MEDICARE: TAMEKA ADEBAYO 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
1	1041C0700X	Clinical Social Worker	0904019829	VA

General Provider Information

NPI Number	:	1750232930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMEKA ADEBAYO LCSW

Provider Business Mailing Address
First Line	:	9604 BIG TREE LN
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-3211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10307 W BROAD ST
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-6716
Country	:	US
Telephone Number	:	804-585-7614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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