Provider Demographics
NPI:1023459187
Name:ADETUNJI, OLUFUNKE OYERONKE (LCPC)
Entity type:Individual
Prefix:
First Name:OLUFUNKE
Middle Name:OYERONKE
Last Name:ADETUNJI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11336 RED OAK TURN
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-3875
Mailing Address - Country:US
Mailing Address - Phone:240-291-8313
Mailing Address - Fax:
Practice Address - Street 1:402 ARMSTRONG CT APT A
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5124
Practice Address - Country:US
Practice Address - Phone:240-291-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4175101YP2500X
TX69464101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional