Provider Demographics
NPI:1295025815
Name:LOCKE, ADEYOLA (LCSW)
Entity Type:Individual
Prefix:
First Name:ADEYOLA
Middle Name:
Last Name:LOCKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E LINCOLN AVE
Mailing Address - Street 2:APT 317
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3532
Mailing Address - Country:US
Mailing Address - Phone:914-297-7898
Mailing Address - Fax:
Practice Address - Street 1:1233 E 233RD STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:914-297-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0778161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical