Provider Demographics
NPI:1497495188
Name:OYELEYE, FOLASADE D (LMSW)
Entity Type:Individual
Prefix:
First Name:FOLASADE
Middle Name:D
Last Name:OYELEYE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1229
Mailing Address - Country:US
Mailing Address - Phone:134-757-9606
Mailing Address - Fax:
Practice Address - Street 1:69 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-1229
Practice Address - Country:US
Practice Address - Phone:347-579-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY115820104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker