Individual provider Active NPI

Oladayo O Oluwalola, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1770240228
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904013366 Issued in VA
Practice address
2528 Las Brisas Dr
Virginia Beach, VA 23456-4264
Phone
(757) 689-0334
NPI assigned
Nov 19, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904013366 VA Primary

Addresses

Primary practice location

2528 Las Brisas Dr
Virginia Beach, VA 23456-4264

Mailing address

2064 Burson Dr
Chesapeake, VA 23323-5304
Phone (317) 529-3370

Other names 1

  • Oladayo O Ogunlola Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20221214002845 VA Practitioner - Clinical Social Worker 1658740675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2064 Burson Dr
Chesapeake, VA 23323-5304
Phone (434) 632-8041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balm of Gilead Counseling Services Clinical CurrentSince Jun 1, 2022 Accepting new patients
Reboot Functional Health Care Corporation Multi-Specialty CurrentSince Jan 21, 2022 Accepting new patients
Beach Counseling, LLC Clinical CurrentSince Nov 21, 2021 Accepting new patients
Balm of Gilead Counseling Services CurrentSince Jan 15, 2023 Accepting new patients

Locations

2528 Las Brisas Dr
Virginia Beach, VA 23456
Phone (757) 301-6985

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1770240228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 BURSON DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233235304",
            "telephone_number": "317-529-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2528 LAS BRISAS DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564264",
            "telephone_number": "757-689-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUWALOLA",
        "first_name": "OLADAYO",
        "middle_name": "O",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLADAYO",
            "last_name": "OGUNLOLA",
            "middle_name": "O",
            "credential": "M.S.W",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.