JESSICA ADESUWA AGBONKPOLO MS, LCSW - NPI 1508609850

Q: What is Jessica Agbonkpolo's NPI number?

The NPI number for Jessica Agbonkpolo is 1508609850. It was assigned to this individual provider in the NPPES registry on June 14, 2024.

Q: What is Jessica Agbonkpolo's specialty?

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

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About Jessica Adesuwa Agbonkpolo Ms, Lcsw NPPES

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

JESSICA ADESUWA AGBONKPOLO MS, LCSW (NPI 1508609850) is an individual mental health provider in San Bernardino, California, licensed in California (111363) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1508609850

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJESSICA ADESUWA AGBONKPOLOCredential: MS, LCSW

Location Address255 N D ST STE 400San Bernardino, CA 92401-1715

Mailing Address255 N D St Ste 400San Bernardino, CA 92401-1715 · (909) 567-2808

Phone(909) 567-2808

Sole ProprietorYes

Enumeration DateJune 14, 2024

NPPES CertifiedJune 14, 2024

✔ NPI 1508609850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in CA · 111363

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 111363 (CA)

255 N D ST STE 400, San Bernardino, CA 92401

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Other Providers at the Same Location NPPES 7

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

YOUTH HOPE LICENSED CLINICAL SOCIAL WORKER CORP

Social Worker (Clinical)