Anthony Vincent Olorunsola, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP7477 Issued in AZ

Practice address

4525 S Lakeshore Dr
Tempe, AZ 85282-8339

Phone

(623) 806-6864

NPI assigned

Jul 23, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Clear Mind Psychiatry and Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1326752809
  NPD Authorized official
• Clear Mind ADHD Treatment Center PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1154012391

  Psychiatric/Mental Health

  NPD (past) Authorized official
• Stepsup LLC

  • Mental Health Counselor
  • Mesa, AZ
  • NPI 1457051948
  NPD

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1205211802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 E SONRISA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852127079",
            "telephone_number": "623-806-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 S LAKESHORE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852828339",
            "telephone_number": "623-806-6864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 W Iron Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852106027",
            "country_code": "US",
            "telephone_number": "623-806-6864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLORUNSOLA",
        "first_name": "ANTHONY",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7477",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP7477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nange Olivacce, NP
• Loralynn Olivarez, LPC
• Cynthia Oliveros
• Jacqueline Oller, MS
• Perry Olliver, DO
• Caroline Olotu, FNP
• Olsen Brothers Dental P.L.L.C.
• Christopher Boyd Olson, D.D.S. ENDODONTIST
• Lauren Olson
• Simona Dolores Olson

• Psychiatric/Mental Health Nurse Practitioner in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.