BOLADALE WURAOLA ADEGOROYE (NPI# 1790174506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790174506 |
| Entity Type | Individual |
| Full Name | BOLADALE WURAOLA ADEGOROYE |
| Practice Address |
768 Duvall Hwy Pasadena MD 21122-1620 |
| Mailing Address |
Po Box 444 Pasadena MD 21123-0444 |
| Practice Telephone | 2404819962 |
| Mailing Telephone | 2404819962 |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2017-02-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LC7193 | MD | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
LC7193 | MD | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
LC7193 | MD | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1155938 00 | 05 |
| Street Address |
768 DUVALL HWY |
| City | PASADENA |
| State | MD |
| Zip Code | 21122-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669911038 | Divine Touch Therapeutic Counseling and Mentoring Services,, LLC | Community/Behavioral Health | 768 Duvall Hwy, Pasadena, MD 21122-1620 | 2017-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889211 | Hyunji Lee | Pharmacist | 8107 Governor Ritchie Highway, Pasadena, MD 21122 | 2020-10-25 |
| 1538712625 | Liri Fusha | Clinic/Center | 8221 Richie Hwy Suit #102, Pasadena, MD 21122 | 2019-07-18 |
| 1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
| 1750849543 | Bradley J Spoon | Counselor | 8028 Ritchie Highway St. 312, Pasadena, MD 21122 | 2019-03-11 |
| 1366916553 | Brittney Byrd | Behavior Technician | 7759 Middlegate Ct, Pasadena, MD 21122 | 2019-01-22 |
| 1780154310 | Amanda Ann Zeller | Speech-Language Pathologist | 8515 Jenkins Road, Pasadena, MD 21122 | 2018-11-27 |
| 1225531544 | Anne Arundel-sca Surgicenter, LLC | Clinic/Center | 8109 Ritchie Hwy Ste 250, Pasadena, MD 21122 | 2018-03-13 |
| 1629577424 | Anne Arundel Physician Group, LLC | Obstetrics & Gynecology | 18 Magothy Beach Road Suite A, Pasadena, MD 21122 | 2018-02-07 |
| 1063968261 | Chinedu Ikpemo | Pharmacist | 8051 Fort Smallwood Rd, Pasadena, MD 21122 | 2016-08-28 |
| 1053728634 | Wisecare, LLC | Clinic/Center | 33 Magothy Beach Rd, Suite 102-103, Pasadena, MD 21122 | 2014-07-16 |
| Find all providers in zip 21122 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972110807 | Stefany Jasmin Zacarias | Counselor | 809 S Marengo Ave, Pasadena, CA 91106-3607 | 2020-09-24 |
| 1386123966 | Andrea Sanchez | Counselor | 3811 Allen Genoa Rd, Pasadena, TX 77504-2723 | 2018-08-14 |
| 1295222396 | Christopher James Boule | Counselor | 3954 Bolivia Dr, Pasadena, TX 77504-2509 | 2018-04-16 |
| 1861846925 | Karla Auces | Counselor | 6914 Elmscott Dr, Pasadena, TX 77505-4409 | 2016-04-14 |
| 1003280504 | Elizabeth K Wills | Counselor | 5151 E Sam Houston Pkwy S, Pasadena, TX 77505-3915 | 2015-11-20 |
| 1972988350 | Coronado Counseling Center | Counselor | 3315 Burke Rd Ste 106, Pasadena, TX 77504-1873 | 2015-07-27 |
| 1356680680 | New Life Addictions Counseling, Inc | Counselor | 2528 Mountain Rd Ste 204, Pasadena, MD 21122-7204 | 2013-02-06 |
| 1801164256 | Kelsey Seifert | Counselor | 4701 Preston Ave, Pasadena, TX 77505-2050 | 2011-12-13 |
| 1346552031 | Harriet Kaiser | Counselor | 1191 E Walnut St # 201, Pasadena, CA 91106-1868 | 2010-07-09 |
| 1639315617 | Charles Richard Roberson Jr. | Counselor | 300 E Walnut St # 200, Pasadena, CA 91101-1584 | 2008-12-23 |
| Find all providers in PASADENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.