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ADELOWO AMOLE MA, LMHC
NPI 1093444101
Counselor - Mental Health in Coram, NY

Active since June 06, 2022PECOS Enrolled
3600 ROUTE 112, CORAM, NY 11727(631) 920-8546(929) 244-4997 Get Directions Write a Review

NPPES record last updated: February 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 19, 2025, Jan 11, 2025, Aug 21, 2023 and 2 more (5 updates tracked since 2022).

About Adelowo Amole Ma, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADELOWO AMOLE MA, LMHC (NPI 1093444101) is an individual mental health provider in Coram, New York, licensed in New York (015463) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1093444101
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameADELOWO AMOLECredential: MA, LMHC
Location Address3600 ROUTE 112Coram, NY 11727-4116
Mailing Address3600 Route 112Coram, NY 11727-4116 · (631) 920-8546 · Fax (929) 244-4997
Phone(631) 920-8546
Fax(929) 244-4997
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 6, 2022
Last NPPES UpdateFebruary 19, 20255 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2025
✔ NPI 1093444101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 015463
3600 ROUTE 112, Coram, NY 11727
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Other Names 1

Other Name (5)Adelowo Amole Ma, Lmhc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Adelowo Amole Ma, Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9638696347
PECOS Enrollment IDI20250506003435
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Adelowo Amole reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Welllife Network Inc.
Same address
Case Management
3600 ROUTE 112
Coram, NY 11727
  • Reassigned Medicare billing, New York enrollment
  • 49 clinicians in this Medicare group
NPI 1386817906 (631) 920-8302

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAQUEL FERNANDES
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
ANNE KIRKHAM
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
JENNIFER HATFIELD
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (630) 920-8500
BIANCA ROLAND
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8302
TRAVIS J WINGATE
Day Training/Habilitation Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8520
JENNIFER WILLA SIEGFRIED
Social Worker
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
SHANNON TIERNEY
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8610
ROSE PRISCILLA SANCHEZ
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8302

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adelowo Amole's NPI number?

The NPI number for Adelowo Amole is 1093444101. It was assigned to this individual provider in the NPPES registry on June 6, 2022. The provider is also known as Adelowo Amole Ma, Lmhc.

Where is Adelowo Amole located?

Adelowo Amole practices at 3600 Route 112, Coram, NY 11727. The listed phone number is (631) 920-8546.

What is Adelowo Amole's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Adelowo Amole enrolled in Medicare?

Yes. Adelowo Amole is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Adelowo Amole's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adelowo Amole reassigns Medicare benefits to Welllife Network Inc. (Coram, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Adelowo Amole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Adelowo Amole was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.