Healthcare Provider Details

I. General information

NPI: 1417805342
Provider Name (Legal Business Name): BAYO OLUSHETO AKINTIMEHIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 SAINT BARNABAS RD # 201
TEMPLE HILLS MD
20748-4604
US

IV. Provider business mailing address

4810 SAINT BARNABAS RD # 201
TEMPLE HILLS MD
20748-4604
US

V. Phone/Fax

Practice location:
  • Phone: 301-674-8695
  • Fax: 301-234-6308
Mailing address:
  • Phone: 301-674-8695
  • Fax: 301-234-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: