MEDICARE: ROSELINE NDIP AYUK

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	101Y00000X	Counselor
2	171M00000X	Case Manager/Care Coordinator
3	172V00000X	Community Health Worker
4	101YA0400X	Addiction (Substance Use Disorder) Counselor	CACII200001266	DC

General Provider Information

NPI Number	:	1528665668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSELINE NDIP AYUK

Provider Business Mailing Address
First Line	:	931 CASLON WAY APT 104
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-6005
Country	:	US
Telephone Number	:	240-877-6297
Fax Number	:

Provider Business Practice Location Address
First Line	:	931 CASLON WAY APT 104
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-6005
Country	:	US
Telephone Number	:	240-877-6297
Fax Number	:

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

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	01/09/2026

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Directions to “ ROSELINE NDIP AYUK ” Practice Location

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