Individual
OMORUYI EPHRAIM OKUNDAYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW-C, LCADC
Contact information
Practice address
16 W 25TH ST, BALTIMORE, MD 21218-5002
(443) 682-5807
Mailing address
PO BOX 7921, ESSEX, MD 21221-0921
(443) 682-5807
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA369
MD
101YM0800X
Mental Health Counselor
Primary
LC17618
MD
101YP1600X
Pastoral Counselor
—
MD
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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