Healthcare Provider Details

I. General information

NPI: 1982477154
Provider Name (Legal Business Name): OHUNENE ADEBAYO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 CANNON RD
SILVER SPRING MD
20904-3321
US

IV. Provider business mailing address

13569 DEMETRIAS WAY
GERMANTOWN MD
20874-2667
US

V. Phone/Fax

Practice location:
  • Phone: 240-970-0770
  • Fax:
Mailing address:
  • Phone: 240-870-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: