Provider Demographics
NPI:1629585328
Name:ADEDEJI, EFUNTOMIWA ARAMIDE (LICSW)
Entity Type:Individual
Prefix:
First Name:EFUNTOMIWA
Middle Name:ARAMIDE
Last Name:ADEDEJI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 IVY CLUB LN APT 1322
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4533
Mailing Address - Country:US
Mailing Address - Phone:240-412-3103
Mailing Address - Fax:
Practice Address - Street 1:1438 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3709
Practice Address - Country:US
Practice Address - Phone:240-743-8956
Practice Address - Fax:202-543-0932
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD168161041C0700X
DCLC500808381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical