Individual provider Active NPI

Folukemi B Olawepo, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1326749177
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1113020 Issued in TX
Practice address
6502 Bandera Rd Ste 200E
San Antonio, TX 78238-1454
Phone
(800) 950-0026
Fax
(702) 952-5257
NPI assigned
Mar 16, 2023
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1113020 TX Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61474799 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 296264 AZ

Addresses

Primary practice location

6502 Bandera Rd Ste 200E
San Antonio, TX 78238-1454

Mailing address

6502 Bandera Rd Ste 200E
San Antonio, TX 78238-1454
Phone (800) 950-0026

Other practice location 1

705 E Broad St Ste 101
Mansfield, TX 76063-6914
Phone (682) 556-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240510000861 WA Practitioner - Nurse Practitioner 2668813445 Reassigns benefits to 1 organization
I20250709000180 TX Practitioner - Nurse Practitioner 2668813445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
296264AZMDPsychiatric/Mental Health Nurse Practitioner
1113020TXMDPsychiatric/Mental Health Nurse Practitioner
AP61474799WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mikkadesh Mental Healthcare LLC Psychiatric/Mental Health CurrentSince Apr 25, 2024 Accepting new patients
Graceland Psychiatric and Neuromodulation Center PLLC CurrentSince Jan 12, 2026 Accepting new patients

Locations

2003 Rogers Rd
Ste 106
San Antonio, TX 78251
Phone (210) 375-5000

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, 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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1326749177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 BANDERA RD STE 200E",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381454",
            "telephone_number": "800-950-0026",
            "fax_number": "702-952-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 BANDERA RD STE 200E",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381454",
            "telephone_number": "800-950-0026",
            "fax_number": "702-952-5257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E Broad St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760636914",
            "country_code": "US",
            "telephone_number": "682-556-6779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLAWEPO",
        "first_name": "FOLUKEMI",
        "middle_name": "B",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1113020",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61474799",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "296264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.