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OLUSEGUN OLUTEDO
NPI 1164196317
Counselor in Mesa, AZ

Active since August 02, 2021
5604 E MAIN ST, MESA, AZ 85205(617) 678-3066 Get Directions Write a Review

NPPES record last updated: May 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2024, Aug 2, 2021 (2 updates tracked since 2021).

About Olusegun Olutedo NPPES

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

OLUSEGUN OLUTEDO (NPI 1164196317) is an individual counselor in Mesa, Arizona and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1164196317
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameOLUSEGUN OLUTEDO
Location Address5604 E MAIN STMesa, AZ 85205-8813
Mailing Address5604 E Main StMesa, AZ 85205-8813 · (617) 678-3066
Phone(617) 678-3066
Sole ProprietorYes
Enumeration DateAugust 2, 2021
Last NPPES UpdateMay 11, 20242 updates tracked since enumeration
NPPES CertifiedMay 11, 2024
✔ NPI 1164196317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
5604 E MAIN ST, Mesa, AZ 85205
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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 Olusegun Olutedo's NPI number?

The NPI number for Olusegun Olutedo is 1164196317. It was assigned to this individual provider in the NPPES registry on August 2, 2021.

Where is Olusegun Olutedo located?

Olusegun Olutedo practices at 5604 E Main St, Mesa, AZ 85205. The listed phone number is (617) 678-3066.

What is Olusegun Olutedo's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Olusegun Olutedo was last updated on May 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.