Provider Demographics
NPI:1891801874
Name:CONTEH, FATU ALPHA (LCSW-C)
Entity type:Individual
Prefix:
First Name:FATU
Middle Name:ALPHA
Last Name:CONTEH
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 FERN ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2331
Mailing Address - Country:US
Mailing Address - Phone:202-726-0998
Mailing Address - Fax:
Practice Address - Street 1:6490 LANDOVER RD
Practice Address - Street 2:SUITE I
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1443
Practice Address - Country:US
Practice Address - Phone:301-583-7888
Practice Address - Fax:301-583-7888
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD432162600Medicaid