Provider Demographics
NPI:1689207847
Name:LAPITE, OLUWAKEMI OLUWASEYI
Entity Type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:OLUWASEYI
Last Name:LAPITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-2030
Mailing Address - Country:US
Mailing Address - Phone:318-512-2857
Mailing Address - Fax:318-388-4961
Practice Address - Street 1:1610 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2030
Practice Address - Country:US
Practice Address - Phone:318-512-2857
Practice Address - Fax:318-388-4961
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA474059534Medicaid