Provider Demographics
NPI:1124265012
Name:OKIBEDI-MOTT, ADAKU (PLCSW)
Entity type:Individual
Prefix:
First Name:ADAKU
Middle Name:
Last Name:OKIBEDI-MOTT
Suffix:
Gender:F
Credentials:PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N. MERRITT AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2636
Mailing Address - Country:US
Mailing Address - Phone:704-305-0210
Mailing Address - Fax:704-216-0286
Practice Address - Street 1:128 N MERRITT AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2636
Practice Address - Country:US
Practice Address - Phone:704-305-0210
Practice Address - Fax:704-216-0286
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPOO3462104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker