Provider Demographics
NPI:1326475252
Name:JONES, OLUFUNMILAYO (LICSW)
Entity Type:Individual
Prefix:
First Name:OLUFUNMILAYO
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:FUNMILAYO
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 MISSISSIPPI AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3862
Mailing Address - Country:US
Mailing Address - Phone:202-671-6426
Mailing Address - Fax:
Practice Address - Street 1:601 MISSISSIPPI AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3862
Practice Address - Country:US
Practice Address - Phone:202-671-6426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50077925104100000X
DCLC500806611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker