Funmilola Omolola Sijuade, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP133711 Issued in TX

Practice address

6505 216TH St SW Ste 100
Mountlake Terrace, WA 98043-2089

Phone

(425) 640-7009

Fax

(425) 640-7009

NPI assigned

May 19, 2017

Last updated

Sep 25, 2024By 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

Enrolled in TX, WA2 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Central Texas Mental Health and Mental Retardation Center

  dba Center for Life Resources

  • Case Management Agency
  • Brownwood, TX
  • NPI 1619196169
  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  TX

  Medicare reassignment
• NSD Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Oro Valley, AZ
  • NPI 1245849231
  Authorized official Same address or phone
• Shaudi Adel, a Licensed Clinical Social Worker, Inc.

  dba Centered Mind Therapy

  • Clinical Social Worker
  • Laguna Beach, CA
  • NPI 1700412129
  NPD

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1447787551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23515 PRATO GARDENS LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774933242",
            "telephone_number": "917-499-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 216TH ST SW STE 100",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432089",
            "telephone_number": "425-640-7009",
            "fax_number": "425-640-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 Allen Pkwy Ste E250",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770191811",
            "country_code": "US",
            "telephone_number": "617-420-1917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIJUADE",
        "first_name": "FUNMILOLA",
        "middle_name": "OMOLOLA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP133711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyenaat Naz Sheikh
• Mark S Shelley, DC
• Shine Life Adult Family Home LLC
• Kyle Shorack
• Christine Ann Sicuro-Fouty, OTR/L
• Mark Alan Silver, MD
• Emily Simmonds, DPT
• Karen Louise Simms, MA, LMHC
• Bryan Simpson, DPT
• Semarn Jyoit Singh

• Psychiatric/Mental Health Nurse Practitioner in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.