Provider Demographics
NPI:1275245680
Name:VOLTAGE MENTAL HEALTH AND COUNSELING CLINIC
Entity Type:Organization
Organization Name:VOLTAGE MENTAL HEALTH AND COUNSELING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLANIRETI
Authorized Official - Middle Name:
Authorized Official - Last Name:ONABANJO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-732-1009
Mailing Address - Street 1:10296 BALTIMORE NATIONAL PIKE STE A
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3670
Mailing Address - Country:US
Mailing Address - Phone:240-732-1009
Mailing Address - Fax:
Practice Address - Street 1:10296 BALTIMORE NATIONAL PIKE STE A
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3670
Practice Address - Country:US
Practice Address - Phone:240-732-1009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOLTAGE MENTAL HEALTH AND COUNSELING CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)