Provider Demographics
NPI:1174337604
Name:OLANIRAN, MONILOLA OMOWUMI (MED QMHP CSAC-S)
Entity type:Individual
Prefix:MRS
First Name:MONILOLA
Middle Name:OMOWUMI
Last Name:OLANIRAN
Suffix:
Gender:F
Credentials:MED QMHP CSAC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14407 BEACHMERE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-6641
Mailing Address - Country:US
Mailing Address - Phone:804-490-8276
Mailing Address - Fax:
Practice Address - Street 1:14407 BEACHMERE DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-6641
Practice Address - Country:US
Practice Address - Phone:804-490-8276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0709025947101YA0400X
VA0732002709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)