Healthcare Provider Details

I. General information

NPI: 1548061591
Provider Name (Legal Business Name): ALEX BABATUNDE AKINSEYE PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12073 TECH RD STE B
SILVER SPRING MD
20904-7874
US

IV. Provider business mailing address

12073 TECH RD STE B
SILVER SPRING MD
20904-7874
US

V. Phone/Fax

Practice location:
  • Phone: 240-477-0077
  • Fax:
Mailing address:
  • Phone: 240-477-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR221506
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: