Provider Demographics
NPI:1760835680
Name:OBARAYE, OLUWAPEMILOLA (LCSW)
Entity Type:Individual
Prefix:
First Name:OLUWAPEMILOLA
Middle Name:
Last Name:OBARAYE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 LOGAN ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3784
Mailing Address - Country:US
Mailing Address - Phone:718-513-0597
Mailing Address - Fax:
Practice Address - Street 1:591 LOGAN ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3784
Practice Address - Country:US
Practice Address - Phone:718-513-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081257-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical