Individual provider Active NPI

Akinola Mobolaji, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Philipsburg, PA
National Provider Identifier
1083022594
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401748 Issued in NY
Practice address
220 N Front St
Ste 301
Philipsburg, PA 16866-1676
Phone
(800) 370-3651
Fax
(860) 510-0020
NPI assigned
Jul 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP015441 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401748 NY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP11181 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5788 CT

Addresses

Primary practice location

220 N Front St
Ste 301
Philipsburg, PA 16866-1676

Mailing address

189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, PA, NY, AZ4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20141126001556 CT Practitioner - Nurse Practitioner 3476875576 Reassigns benefits to 3 organizations
I20170712000247 PA Practitioner - Nurse Practitioner 3476875576 Reassigns benefits to 1 organization
I20250512000277 NY Practitioner - Nurse Practitioner 3476875576 Reassigns benefits to 1 organization
I20250515002713 AZ Practitioner - Nurse Practitioner 3476875576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Natchaug Hospital, IncGroup PAC ID 5395648737, 34 clinicians
Lswhb, LLCGroup PAC ID 9638414204, 21 clinicians

Practice addresses (Care Compare)

189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311

290 Western Blvd
Glastonbury, CT 06033-1236
Phone (860) 652-3325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP11181AZMDPsychiatric/Mental Health Nurse Practitioner
401748NYMDPsychiatric/Mental Health Nurse Practitioner
SP015441PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Natchaug Hospital, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Apr 16, 2025 Accepting new patients
Lswhb LLC CurrentSince May 1, 2025 Accepting new patients
B Nelson LLC Psychiatric/Mental Health PastSince Jan 1, 2021 Accepting new patients
Prohealth Physicians PC Past Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

290 Western Blvd
Glastonbury, CT 06033
Phone (860) 652-3325

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

141 Willard Ave
Newington, CT 06111
Phone (860) 666-5601

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

Interoperability endpoints

  • Direct secure messaging: akinola.mobolaji@xdr.hhchealthdirect.org

Organizations & group practices 5

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1083022594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501683",
            "telephone_number": "860-456-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N FRONT ST",
            "address_2": "STE 301",
            "city": "PHILIPSBURG",
            "state": "PA",
            "postal_code": "168661676",
            "telephone_number": "800-370-3651",
            "fax_number": "860-510-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBOLAJI",
        "first_name": "AKINOLA",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP015441",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401748",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP11181",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "5788",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philipsburg, PA

Sources for this page

Verify at the official NPI Registry.