Oluwatoyin Y Fawole, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017425 Issued in PA

Practice address

4510 Frankford Ave
2ND Floor
Philadelphia, PA 19124-1017

Phone

(215) 831-9882

Fax

(215) 831-9887

NPI assigned

Oct 31, 2007

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 PA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oluwatoyin.fawole.p1@direct.gpha.nextgenshare.com

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.

• Greater Philadelphia Health Action Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1205140902
  Medicare reassignment NPD
• Greater Philadelphia Health Action Inc.

  • Dental Clinic/Center
  • Philadelphia, PA
  • NPI 1710040878
  NPD
• Greater Philadelphia Health Action, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1275151607
  NPD

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1710166236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 FRANKFORD AVE",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191241017",
            "telephone_number": "215-831-9882",
            "fax_number": "215-831-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWOLE",
        "first_name": "OLUWATOYIN",
        "middle_name": "Y",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuelle Sarah Favilla, M.D.
• Jibraan Ahmed Fawad
• William James Fawcett, CRNP
• Kara Devers Fawley, PSYD
• Adedamola Fawole
• Douglas Faxon, Jr., MS
• Kevin Scott Fay, M.D.
• Oluwadamilola Motunrayo Fayanju, M.D.
• Faye Home Healthcare LLC
• Kyle Faye, CRNP, DNP

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.