Healthcare Provider Details

I. General information

NPI: 1588024582
Provider Name (Legal Business Name): FOLASADE ODEGBILE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 UNIVERSITY BLVD W THE PATHWAYS SCHOOLS
SILVER SPRING MD
20902-3302
US

IV. Provider business mailing address

1106 UNIVERSITY BLVD W THE PATHWAYS SCHOOLS
SILVER SPRING MD
20902-3302
US

V. Phone/Fax

Practice location:
  • Phone: 301-649-0778
  • Fax:
Mailing address:
  • Phone: 301-649-0778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18365
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104466
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: