Individual provider Active NPI

Adekunle J Gbadamosi, LPC

  • Mental Health Counselor
  • Coatesville, PA
National Provider Identifier
1295343929
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC-0000630 Issued in DE
Practice address
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Phone
(610) 384-7711
NPI assigned
Jul 20, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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 PC-0000630 DE Primary

Addresses

Primary practice location

1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040

Mailing address

2 Corkwood LN
New Castle, DE 19720-7670
Phone (302) 384-3194

Other practice location 1

1508 Pennsylvania Ave
Wilmington, DE 19806-4338
Phone (302) 427-8000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC-0000630DEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health & Wellness Services, LLC CurrentSince Jun 3, 2020 Accepting new patients

Locations

1508 Pennsylvania Ave
Ste 1C
Wilmington, DE 19806
Phone (302) 427-8000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22998/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1295343929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CORKWOOD LN",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197207670",
            "telephone_number": "302-384-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BLACKHORSE HILL RD",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193202040",
            "telephone_number": "610-384-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198064338",
            "country_code": "US",
            "telephone_number": "302-427-8000",
            "fax_number": "302-601-5583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GBADAMOSI",
        "first_name": "ADEKUNLE",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-20",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC-0000630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coatesville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.