Provider Demographics
NPI:1114650785
Name:AKINDURO, ANTHONY AKINPELU (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:AKINPELU
Last Name:AKINDURO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WILLIS AVE # 1
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3115
Mailing Address - Country:US
Mailing Address - Phone:917-553-6411
Mailing Address - Fax:
Practice Address - Street 1:24 WILLIS AVE # 1
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3115
Practice Address - Country:US
Practice Address - Phone:917-553-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst