Individual provider Active NPI

Olayinka Samuel Fawehinmi, MSCM

  • Counselor
  • Providence, RI
National Provider Identifier
1063254001
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
188 Academy Ave
Providence, RI 02908-4452
Phone
(405) 509-1011
NPI assigned
Jun 11, 2024
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

188 Academy Ave
Providence, RI 02908-4452

Mailing address

188 Academy Ave
Providence, RI 02908-4452
Phone (405) 509-1011

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1063254001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 ACADEMY AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084452",
            "telephone_number": "405-509-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 ACADEMY AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084452",
            "telephone_number": "405-509-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWEHINMI",
        "first_name": "OLAYINKA",
        "middle_name": "SAMUEL",
        "credential": "MSCM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.