Individual provider Active NPI

Joshua Nosa Okundaye, PH.D., LCSW-C

  • Social Worker
  • Upper Marlboro, MD
National Provider Identifier
1013072909
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
08340 Issued in MD
Practice address
14526 Church St
Upper Marlboro, MD 20772-3040
Phone
(301) 574-4200
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 08340 MD Primary

Addresses

Primary practice location

14526 Church St
Upper Marlboro, MD 20772-3040

Mailing address

14526 Church St
Upper Marlboro, MD 20772-3040
Phone (301) 574-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
08340MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. O & Okundaye, LLC Current Accepting new patients
Another Spring Counseling and Psychotherapy Services LLC Current Accepting new patients

Locations

9520 Pennsylvania Ave
Ste 201
Uppr Marlboro, MD 20772
Phone (301) 957-7210

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1013072909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14526 CHURCH ST",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723040",
            "telephone_number": "301-574-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14526 CHURCH ST",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723040",
            "telephone_number": "301-574-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNDAYE",
        "first_name": "JOSHUA",
        "middle_name": "NOSA",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "08340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.