Teniola O Osundeko, LCSW, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CWO14920 Issued in PA

Practice address

25 E Park Ave
Suite 1
Du Bois, PA 15801-2271

Phone

(814) 591-7169

Fax

(814) 746-4174

NPI assigned

Oct 19, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114916418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 GREEN GLEN DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158013216",
            "telephone_number": "814-746-4174",
            "fax_number": "814-746-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E PARK AVE",
            "address_2": "SUITE 1",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012271",
            "telephone_number": "814-591-7169",
            "fax_number": "814-746-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSUNDEKO",
        "first_name": "TENIOLA",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "LCSW, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CWO14920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.