Individual provider Active NPI

Ibiyemi Oluwabiyi, LGPC

  • Professional Counselor
  • Edgewood, MD
National Provider Identifier
1538766936
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LGP8687 Issued in MD
Practice address
1308 Business Center Way Ste 101
Edgewood, MD 21040-1504
Phone
(240) 253-3977
NPI assigned
Oct 8, 2020
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LGP8687 MD Primary

Addresses

Primary practice location

1308 Business Center Way Ste 101
Edgewood, MD 21040-1504

Mailing address

7355 Granite Woods CT
Windsor Mill, MD 21244-1655
Phone (410) 944-0400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801002563 MD Practitioner - Mental Health Counselor 2062959554 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP8687MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Counseling LLC Single Specialty CurrentSince Jul 22, 2024 Accepting new patients
Divine Counseling LLC CurrentSince Aug 4, 2024 Accepting new patients
Stillwaters Consulting CurrentSince Jan 17, 2022 Accepting new patients

Locations

90 Painters Mill Rd
Ste 135136
Owings Mills, MD 21117
Phone (443) 955-2662

1829 Reisterstown Rd
Ste 350
Pikesville, MD 21208
Phone (443) 226-1676

Organizations & group practices 3

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": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1538766936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 GRANITE WOODS CT",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212441655",
            "telephone_number": "410-944-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 BUSINESS CENTER WAY STE 101",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401504",
            "telephone_number": "240-253-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUWABIYI",
        "first_name": "IBIYEMI",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP8687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, MD

Sources for this page

Verify at the official NPI Registry.