Provider Demographics
NPI:1255041711
Name:LAWAL, SADIQ OLADAPO
Entity type:Individual
Prefix:MR
First Name:SADIQ
Middle Name:OLADAPO
Last Name:LAWAL
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 1:62 FREDERICK ST APT 32
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3450
Mailing Address - Country:US
Mailing Address - Phone:774-417-7473
Mailing Address - Fax:
Practice Address - Street 1:606 FARMS DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3746
Practice Address - Country:US
Practice Address - Phone:774-417-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-24
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20R8-0L3V-STLT103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling