MEDICARE: OLUREMI O EREKU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4046	MN
2	106H00000X	Marriage & Family Therapist	4046	MN

General Provider Information

NPI Number	:	1417537143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUREMI O EREKU

Provider Business Mailing Address
First Line	:	4810 N 133RD PLZ APT 521
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-1018
Country	:	US
Telephone Number	:	612-703-2520
Fax Number	:	612-486-8554

Provider Business Practice Location Address
First Line	:	2100 EMERSON AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2512
Country	:	US
Telephone Number	:	612-703-2520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	01/08/2026

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Directions to “ OLUREMI O EREKU ” Practice Location

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