Provider Demographics
NPI:1659027761
Name:AYOOLA, AMEDE JOIOPUTA (LICSW)
Entity Type:Individual
Prefix:
First Name:AMEDE
Middle Name:JOIOPUTA
Last Name:AYOOLA
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 1:2610 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2871
Mailing Address - Country:US
Mailing Address - Phone:313-350-7693
Mailing Address - Fax:
Practice Address - Street 1:200 I ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3317
Practice Address - Country:US
Practice Address - Phone:202-368-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500809401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical