Provider Demographics
NPI:1629516596
Name:SHODEINDE, OLUDAMILOLA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:OLUDAMILOLA
Middle Name:
Last Name:SHODEINDE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 AXTON CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2050
Mailing Address - Country:US
Mailing Address - Phone:301-273-5202
Mailing Address - Fax:
Practice Address - Street 1:9701 PHILADELPHIA CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4400
Practice Address - Country:US
Practice Address - Phone:301-477-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500806311041C0700X
MD164051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical