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NPI Code Detail

MEDICARE: KARIDJA STEPHANIE GOHOURE

MEDICARE: KARIDJA STEPHANIE GOHOURE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCACII200001213DC
2104100000XSocial WorkerLG200006892DC

General Provider Information

NPI Number : 1447950647
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARIDJA STEPHANIE GOHOURE
Provider Business Mailing Address
First Line : 1720 HARTSDALE RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21239-3709
Country : US
Telephone Number : 240-701-2670
Fax Number :
Provider Business Practice Location Address
First Line : 1221 TAYLOR ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-5617
Country : US
Telephone Number : 202-464-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2023
Last Update Date : 05/19/2026

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Directions to “ KARIDJA STEPHANIE GOHOURE ” Practice Location

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