Individual provider Active NPI

Isaac Abioye Olasupo, MSC

  • Cognitive & Behavioral Psychologist
  • Baltimore, MD
National Provider Identifier
1669405270
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
408449700, 409426300 Issued in MD
Practice address
2116 N Charles St
Suit 300
Baltimore, MD 21218-5758
Phone
(410) 244-0331
Fax
(410) 244-7364
NPI assigned
Jul 8, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MD
Mental Health Counselor 101YM0800X MD
Cognitive & Behavioral Psychologist 103TB0200X 408449700, 409426300 MD Primary
Rehabilitation Psychologist 103TR0400X MD

Addresses

Primary practice location

2116 N Charles St
Suit 300
Baltimore, MD 21218-5758

Mailing address

6510 Jodie St
New Carrollton, MD 20784-3636
Phone (301) 345-4787

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
408449700MDMDAddiction (Substance Use Disorder) Counselor
408449700, 409426300MDMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reward Health Services, LLC Past Accepting new patients

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1669405270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 JODIE ST",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207843636",
            "telephone_number": "301-345-4787",
            "fax_number": "301-345-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 N CHARLES ST",
            "address_2": "SUIT 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185758",
            "telephone_number": "410-244-0331",
            "fax_number": "410-244-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLASUPO",
        "first_name": "ISAAC",
        "middle_name": "ABIOYE",
        "name_prefix": "Mr.",
        "credential": "MSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MD",
            "license": "408449700, 409426300",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.