Olabisi Fashuyi Fafore

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15240800 Issued in NJ

Practice address

11340 Lakefield Dr
Johns Creek, GA 30097-1714

Phone

(470) 242-6344

NPI assigned

Sep 21, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, GA, WA, NY, TX, AK6 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 6

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AK, GA, NY, Psychiatric/Mental Health, TX, WA

  Medicare reassignment NPD
• Cornerstone Mental Health Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Creek, GA
  • NPI 1467266106
  NPD Authorized official

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

{
    "created_epoch": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1841017944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 LANIER SPRINGS DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305187272",
            "telephone_number": "612-227-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 LAKEFIELD DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971714",
            "telephone_number": "470-242-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAFORE",
        "first_name": "OLABISI",
        "middle_name": "FASHUYI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-21",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN297527",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15240800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enhanced Wellness Clinics
• Syamala D Erramilli, MD
• Valentina Espinosa, D.M.D.
• Etheric Glo & Co.LLC
• Madison Exum, PA-C
• Hannah Degrange Fairley, RN
• Niva M. Falk, MS, CCC-SLP
• Family Feeding Connections: Lactation and Feeding Therapy LLC
• Joseph Michael Fanning III, D.C.
• Nicholas Farber, MD

• Psychiatric/Mental Health Nurse Practitioner in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.