Healthcare Provider Details

I. General information

NPI: 1053027771
Provider Name (Legal Business Name): TOYIN HOPE OBAJINMI LPC, ADC INTERN, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS TOYIN HOPE OMIYE

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 S LINCOLN AVE
VINELAND NJ
08361-6660
US

IV. Provider business mailing address

1301 S LINCOLN AVE
VINELAND NJ
08361-6660
US

V. Phone/Fax

Practice location:
  • Phone: 609-516-3203
  • Fax:
Mailing address:
  • Phone: 609-516-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2022-000088
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00844600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: