MEDICARE: NGWENYI TITA

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
2	171M00000X	Case Manager/Care Coordinator		DC

General Provider Information

NPI Number	:	1295608677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGWENYI TITA

Provider Business Mailing Address
First Line	:	6926 ANDERSONS WAY APT 102
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-5279
Country	:	US
Telephone Number	:	402-202-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	6926 ANDERSONS WAY APT 102
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-5279
Country	:	US
Telephone Number	:	402-202-0016
Fax Number	:

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

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	06/05/2026

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Directions to “ NGWENYI TITA ” Practice Location

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