Individual provider Active NPI

Foluso O Otuyelu, LCSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1104009380
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072921 Issued in NY
Practice address
14 Slosson Ter
Staten Island, NY 10301-2507
Phone
(718) 720-6727
Fax
(718) 720-0326
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072921 NY Primary

Addresses

Primary practice location

14 Slosson Ter
Staten Island, NY 10301-2507

Mailing address

14 Slosson Ter
Staten Island, NY 10301-2507
Phone (718) 720-6727

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

State licenses

LicenseStateTypeSpecialty
072921NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soar With Foluso LCSW Services PLLC Clinical PastSince Mar 5, 2023 Accepting new patients
MC Queen and Otuyelu LCSW Wellness Clinical PastSince Jul 28, 2019 Accepting new patients

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": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1104009380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SLOSSON TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012507",
            "telephone_number": "718-720-6727",
            "fax_number": "718-720-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 SLOSSON TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012507",
            "telephone_number": "718-720-6727",
            "fax_number": "718-720-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTUYELU",
        "first_name": "FOLUSO",
        "middle_name": "O",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.