=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295504447
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LOLALI ADADE-HELLEDY PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2023
-----------------------------------------------------
Last Update Date | 12/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13941 CARTHAGE CIR
-----------------------------------------------------
City | BURTONSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20866-2007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-421-1576
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13941 CARTHAGE CIR
-----------------------------------------------------
City | BURTONSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20866-2007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-421-1576
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | NP200003210
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------