Provider Demographics
NPI:1306724422
Name:OKEREKE, SALOME O (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SALOME
Middle Name:O
Last Name:OKEREKE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3557
Mailing Address - Country:US
Mailing Address - Phone:617-943-9699
Mailing Address - Fax:
Practice Address - Street 1:117 BROADWAY
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3557
Practice Address - Country:US
Practice Address - Phone:339-502-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2025061102363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health