1487358222 NPI number — IYINOLUWA OLUWATOLA LCSW, LCADC

Table of content: FERN REEVES LMHC (NPI 1922076850)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487358222 NPI number — IYINOLUWA OLUWATOLA LCSW, LCADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLUWATOLA
Provider First Name:
IYINOLUWA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, LCADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487358222
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2933 VAUXHALL RD STE 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VAUXHALL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07088-1248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
929-888-7956
Provider Business Mailing Address Fax Number:
929-788-4356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 PARK ST STE 310
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTCLAIR
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07042-2960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
929-888-7956
Provider Business Practice Location Address Fax Number:
929-778-4356
Provider Enumeration Date:
03/27/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC06577300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: 37LC00396200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com