Provider Demographics
NPI:1356130835
Name:NGONGHA, ALLO JOSEPH
Entity type:Individual
Prefix:
First Name:ALLO
Middle Name:JOSEPH
Last Name:NGONGHA
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 1:8733 CONTEE RD APT 203
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1917
Mailing Address - Country:US
Mailing Address - Phone:202-807-7164
Mailing Address - Fax:
Practice Address - Street 1:8733 CONTEE RD APT 203
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1917
Practice Address - Country:US
Practice Address - Phone:202-807-7164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MD1356130835171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)