Healthcare Provider Details

I. General information

NPI: 1336568138
Provider Name (Legal Business Name): OLAYINKA I AKEJU LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 RIVERWALK BLVD
BURLINGTON TOWNSHIP NJ
08016
US

IV. Provider business mailing address

PO BOX 147
BURLINGTON NJ
08016-0147
US

V. Phone/Fax

Practice location:
  • Phone: 609-699-6676
  • Fax:
Mailing address:
  • Phone: 609-699-6766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3PC00613100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: