Provider Demographics
NPI:1194503052
Name:OSEMWEGIE, ADESUWA LAURETTA (LCPC)
Entity type:Individual
Prefix:MS
First Name:ADESUWA
Middle Name:LAURETTA
Last Name:OSEMWEGIE
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 1:2700 LIGHTHOUSE PT E STE 260
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4791
Mailing Address - Country:US
Mailing Address - Phone:301-919-0882
Mailing Address - Fax:410-801-9672
Practice Address - Street 1:2700 LIGHTHOUSE PT E STE 260
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4791
Practice Address - Country:US
Practice Address - Phone:301-919-0882
Practice Address - Fax:410-801-9672
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7250101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor