Provider Demographics
NPI:1700762556
Name:EKWET TAMBE ACHUO, ALES
Entity type:Individual
Prefix:
First Name:ALES
Middle Name:
Last Name:EKWET TAMBE ACHUO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9963 GOOD LUCK RD APT 103
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3274
Mailing Address - Country:US
Mailing Address - Phone:256-951-0225
Mailing Address - Fax:
Practice Address - Street 1:4411 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5639
Practice Address - Country:US
Practice Address - Phone:256-951-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty