Provider Demographics
NPI:1891269296
Name:AKINNOLA, STEPHEN I
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:I
Last Name:AKINNOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 CAMBERWELL LN
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-3121
Mailing Address - Country:US
Mailing Address - Phone:240-381-9413
Mailing Address - Fax:
Practice Address - Street 1:631 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1228
Practice Address - Country:US
Practice Address - Phone:410-354-2000
Practice Address - Fax:410-354-9469
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)