Provider Demographics
NPI:1710495361
Name:ADENEKAN, JOY ADEFOLUKE
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:ADEFOLUKE
Last Name:ADENEKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JOY
Other - Middle Name:ADEFOLUKE
Other - Last Name:FAGBENRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HHA
Mailing Address - Street 1:11006 RAWLINGS CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-8153
Mailing Address - Country:US
Mailing Address - Phone:301-728-3094
Mailing Address - Fax:
Practice Address - Street 1:4130 HUNT PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3565
Practice Address - Country:US
Practice Address - Phone:202-388-4300
Practice Address - Fax:202-388-4339
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13439374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide