SAMUEL BOMO KOROMA
NPI 1619612934
Psychologist - Group Psychotherapy in Washington, DC

Q: What is Samuel Koroma's NPI number?

The NPI number for Samuel Koroma is 1619612934. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Q: What is Samuel Koroma's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Group Psychotherapy, with taxonomy code 103TP2701X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Koroma was last updated on December 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 02, 2022PECOS Enrolled

920 BELLEVUE ST SE, WASHINGTON, DC 20032(202) 562-4939 Get Directions Write a Review

NPPES record last updated: December 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 16, 2022, May 2, 2022 (2 updates tracked since 2022).

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About Samuel Bomo Koroma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL BOMO KOROMA (NPI 1619612934) is an individual group psychotherapy provider in Washington, District Of Columbia and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Washington.

NPPES Registry Identity

NPI1619612934

Entity TypeIndividualMale

Primary Taxonomy103TP2701X

Provider Legal NameSAMUEL BOMO KOROMA

Location Address920 BELLEVUE ST SEWashington, DC 20032-6030

Mailing Address1140 3rd St NeWashington, DC 20002-6274

Phone(202) 562-4939

Sole ProprietorYes

Enumeration DateMay 2, 2022

Last NPPES UpdateDecember 21, 20232 updates tracked since enumeration

NPPES CertifiedDecember 21, 2023

✔ NPI 1619612934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Group PsychotherapyBehavioral Health & Social Service Providers

Taxonomy Code103TP2701X

Definition

A psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings.

Also ListedCounselorTaxonomy 101Y00000X · License LC50078067 (DC)

920 BELLEVUE ST SE, Washington, DC 20032

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Secondary Practice Location 1

Location 11140 3rd St NEWashington, DC 20002-6274 · Phone (202) 500-6617

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Bomo Koroma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TARA MONIQUE JACKSON

Case Manager/Care Coordinator