Individual provider Active NPI

Adelowo Amole, MA, LMHC

  • Mental Health Counselor
  • Coram, NY
National Provider Identifier
1093444101
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015463 Issued in NY
Practice address
3600 Route 112
Coram, NY 11727-4116
Phone
(631) 920-8546
Fax
(929) 244-4997
NPI assigned
Jun 6, 2022
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 015463 NY Primary

Addresses

Primary practice location

3600 Route 112
Coram, NY 11727-4116

Mailing address

3600 Route 112
Coram, NY 11727-4116
Phone (631) 920-8546

Other names 1

  • Adelowo Amole Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506003435 NY Practitioner - Mental Health Counselor 9638696347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Welllife Network IncGroup PAC ID 0749179570, 17 clinicians

Practice addresses (Care Compare)

3600 Route 112
Coram, NY 11727-4116
Phone (631) 920-8302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Welllife Network Inc. CurrentSince Apr 11, 2025 Accepting new patients
Welllife Network Inc CurrentSince Apr 11, 2025 Accepting new patients
Welllife Network Inc., Current Accepting new patients

Locations

3600 Route 112
Coram, NY 11727
Phone (631) 854-2100

14202 20th Ave
#3
Flushing, NY 11351

14202 20th Ave
Fl 3
Flushing, NY 11351
Phone (718) 559-0516

800 Northern Blvd
Great Neck, NY 11021
Phone (516) 829-8450

1985 Marcus Ave
Ste 100
New Hyde Park, NY 11042
Phone (347) 265-9985

20905 Jamaica Ave
Queens Village, NY 11428
Phone (631) 920-8302

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1093444101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8546",
            "fax_number": "929-244-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8546",
            "fax_number": "929-244-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOLE",
        "first_name": "ADELOWO",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADELOWO",
            "last_name": "AMOLE",
            "credential": "MA, LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coram, NY

Sources for this page

Verify at the official NPI Registry.