Healthcare Provider Details

I. General information

NPI: 1710809033
Provider Name (Legal Business Name): OLUFEMI SHITTU
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 CHAPEL HILL RD
DURHAM NC
27707-1109
US

IV. Provider business mailing address

1112 MCCORMICK ST
GREENSBORO NC
27403-2932
US

V. Phone/Fax

Practice location:
  • Phone: 919-341-6111
  • Fax:
Mailing address:
  • Phone: 336-708-3117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPO2116
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: