Provider Demographics
NPI:1093485898
Name:OYEFUSI, JESSICA (LCPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:OYEFUSI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 BELCREST CENTER DR # 1009
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1912
Mailing Address - Country:US
Mailing Address - Phone:214-991-2022
Mailing Address - Fax:
Practice Address - Street 1:2950 BELCREST CENTER DR # 1009
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1912
Practice Address - Country:US
Practice Address - Phone:469-251-0785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013448101YP2500X
TX836639101YP2500X
DEPC-0011542101YP2500X
DCPRC200002035101YP2500X
MDLC14991101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000OtherN/A