Provider Demographics
NPI:1285130054
Name:ONITIRI, KUDIRAT A (EDS, LCADC, LMFT)
Entity type:Individual
Prefix:
First Name:KUDIRAT
Middle Name:A
Last Name:ONITIRI
Suffix:
Gender:F
Credentials:EDS, LCADC, LMFT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:ONITIRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDS, LCADC, LMFT
Mailing Address - Street 1:2052 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08629-2210
Mailing Address - Country:US
Mailing Address - Phone:609-508-3865
Mailing Address - Fax:
Practice Address - Street 1:TCNJ CCC FORCINA HALL
Practice Address - Street 2:2000 PENNINGTON RD. SUITE 413
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628
Practice Address - Country:US
Practice Address - Phone:609-429-0867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00239100101YA0400X
NJ37FI001972106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)