Adepeju Ibironke Faboro Oshaughnessy, L.M.H.C, L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16093 Issued in FL

Practice address

44 Bucktail Ave
Ponte Vedra, FL 32081-6181

Phone

(405) 473-4945

NPI assigned

Sep 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Adepeju Ibironke Faboro Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: adepejuoshaughnessy@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1284249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1679880678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BUCKTAIL AVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816181",
            "telephone_number": "405-473-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BUCKTAIL AVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816181",
            "telephone_number": "405-473-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHAUGHNESSY",
        "first_name": "ADEPEJU",
        "middle_name": "IBIRONKE FABORO",
        "name_prefix": "Mrs.",
        "credential": "L.M.H.C, L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-12",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "6063",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81315",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331240B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADEPEJU",
            "last_name": "FABORO",
            "middle_name": "IBIRONKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.