Provider Demographics
NPI:1487019626
Name:OLOWOYEYE, OLANREWAJU FELIX (LCASA)
Entity Type:Individual
Prefix:
First Name:OLANREWAJU
Middle Name:FELIX
Last Name:OLOWOYEYE
Suffix:
Gender:M
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 COURTNEY LN APT C
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5251
Mailing Address - Country:US
Mailing Address - Phone:919-673-9283
Mailing Address - Fax:
Practice Address - Street 1:130 E MORGAN ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1410
Practice Address - Country:US
Practice Address - Phone:919-835-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22316101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)