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NPI Code Detail

MEDICARE: MR. ABAYOMI OBABUNMI ADEBOWALE MS, LPCMH, NCC

MEDICARE: MR. ABAYOMI OBABUNMI ADEBOWALE MS, LPCMH, NCC
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
1101YM0800XMental Health CounselorPC0000550DE

General Provider Information

NPI Number : 1558649616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ABAYOMI OBABUNMI ADEBOWALE MS, LPCMH, NCC
Provider Business Mailing Address
First Line : 501 SILVERSIDE RD
Second Line : SUITE # 74
City : WILMINGTON
State : DE
Zip : 19809-1374
Country : US
Telephone Number : 302-377-6225
Fax Number :
Provider Business Practice Location Address
First Line : 501 SILVERSIDE RD
Second Line : SUITE # 74
City : WILMINGTON
State : DE
Zip : 19809-1374
Country : US
Telephone Number : 302-377-6225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2011
Last Update Date : 06/11/2014

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