MEDICARE: SUSIE ASAMOAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LG200004723	DC
2	171M00000X	Case Manager/Care Coordinator		DC
3	172V00000X	Community Health Worker		DC

General Provider Information

NPI Number	:	1184568875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSIE ASAMOAH

Provider Business Mailing Address
First Line	:	4851 ELLIN RD APT 265
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1775
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 MINNESOTA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-2662
Country	:	US
Telephone Number	:	646-750-1292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	05/26/2026

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Directions to “ SUSIE ASAMOAH ” Practice Location

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