Provider Demographics
NPI:1902440134
Name:OLAKANYE, TOSIN ESTHER
Entity Type:Individual
Prefix:
First Name:TOSIN
Middle Name:ESTHER
Last Name:OLAKANYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6790 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-2131
Mailing Address - Country:US
Mailing Address - Phone:954-842-8140
Mailing Address - Fax:
Practice Address - Street 1:6790 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-2131
Practice Address - Country:US
Practice Address - Phone:954-842-8140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCMHP100032101YM0800X
FLMCAP100733101YP2500X, 261QC1500X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)