Provider Demographics
NPI:1164301198
Name:CHOFONG, CLETUS ALOT
Entity type:Individual
Prefix:
First Name:CLETUS
Middle Name:ALOT
Last Name:CHOFONG
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 1:12303 RONALD BEALL RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5682
Mailing Address - Country:US
Mailing Address - Phone:240-838-9559
Mailing Address - Fax:
Practice Address - Street 1:12303 RONALD BEALL RD
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5682
Practice Address - Country:US
Practice Address - Phone:240-838-9559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor