Individual
FATAI ADESHINA POPOOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW,LADC
Contact information
Practice address
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415-1533
(612) 396-2280
Mailing address
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415-1533
(612) 396-2280
(612) 466-9432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303521
MN
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
24938
MN
Other
Enumeration date
10/27/2017
Last updated
02/06/2025
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