Provider Demographics
NPI:1700575123
Name:GBELEYE, KAYODE RICHARD (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KAYODE
Middle Name:RICHARD
Last Name:GBELEYE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5427 FRANKFORD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3560
Mailing Address - Country:US
Mailing Address - Phone:443-221-1043
Mailing Address - Fax:
Practice Address - Street 1:1012 NORTHPOINT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3338
Practice Address - Country:US
Practice Address - Phone:443-216-4800
Practice Address - Fax:443-216-4801
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2372102084P0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry