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NPI Code Detail

MEDICARE: IBUKUN ADIJI LCSW

MEDICARE: IBUKUN ADIJI LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor63517TX
21041C0700XClinical Social Worker63517TX

General Provider Information

NPI Number : 1063094654
Entity Type Code : Individual
Provider Name (Legal Business Name) : IBUKUN ADIJI LCSW
Provider Business Mailing Address
First Line : 7116 LANYON DR
Second Line :
City : DALLAS
State : TX
Zip : 75227-2766
Country : US
Telephone Number : 469-929-3496
Fax Number :
Provider Business Practice Location Address
First Line : 7116 LANYON DR
Second Line :
City : DALLAS
State : TX
Zip : 75227-2766
Country : US
Telephone Number : 469-929-3496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2021
Last Update Date : 03/04/2026

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Directions to “ IBUKUN ADIJI LCSW” Practice Location

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