Provider Demographics
NPI:1346091162
Name:AFONJA, ADEMOLA (MSW)
Entity Type:Individual
Prefix:
First Name:ADEMOLA
Middle Name:
Last Name:AFONJA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-3107
Mailing Address - Country:US
Mailing Address - Phone:917-355-6997
Mailing Address - Fax:
Practice Address - Street 1:2100 KECOUGHTAN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-3215
Practice Address - Country:US
Practice Address - Phone:917-355-6997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical