Provider Demographics
NPI:1952996001
Name:BABATUNDE, OLUWAKEMI O (LPC-A)
Entity Type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:O
Last Name:BABATUNDE
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:OLUWAKEMI
Other - Middle Name:O
Other - Last Name:ABIWO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:647 CHEEHAW AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-2276
Mailing Address - Country:US
Mailing Address - Phone:803-238-4712
Mailing Address - Fax:
Practice Address - Street 1:4344 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4010
Practice Address - Country:US
Practice Address - Phone:803-238-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health