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General NPI Number Information
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NPI Number | 1679939656
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Entity Type | Individual
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Provider Name | TEMITOPE SHAKIRAT OLUGUNA LCSW, LCADC
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Gender | Female
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 45 ACADEMY ST STE 303
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City | NEWARK
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State | NJ
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Zip | 07102-2900
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Country | US
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Telephone | 973-878-3900
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Fax | 973-878-3809
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Provider Business Mailing Address
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Address Line | 45 ACADEMY ST STE 303
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City | NEWARK
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State | NJ
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Zip | 07102-2900
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Country | US
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Telephone | 973-878-3900
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Fax | 973-878-3809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00242600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SC05667800
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License Number State | NJ
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