Individual provider Active NPI

Adebukola Olufotebi, MS, LPC, NCC

  • Professional Counselor
  • Washington, DC
National Provider Identifier
1811673460
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
712 H St NE Ste 1851
Washington, DC 20002-3627
Phone
(202) 505-1916
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X DC Primary

Addresses

Primary practice location

712 H St NE Ste 1851
Washington, DC 20002-3627

Mailing address

712 H St NE Ste 1851
Washington, DC 20002-3627
Phone (202) 743-5190

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Fortitude Wellness Collective, LLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

712 H St NE
Ste 1851
Washington, DC 20002
Phone (202) 505-1916

Organizations & group practices 1

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1811673460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 H ST NE STE 1851",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023627",
            "telephone_number": "202-743-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 H ST NE STE 1851",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023627",
            "telephone_number": "202-505-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUFOTEBI",
        "first_name": "ADEBUKOLA",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.