Provider Demographics
NPI:1306404058
Name:ADEBULE, FAITH (PSYD)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:
Last Name:ADEBULE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:AREMU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:518 S CAMP MEADE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2766
Mailing Address - Country:US
Mailing Address - Phone:443-623-3592
Mailing Address - Fax:443-478-3949
Practice Address - Street 1:518 S CAMP MEADE RD STE 1
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-2766
Practice Address - Country:US
Practice Address - Phone:443-623-3592
Practice Address - Fax:443-478-3949
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MDLC8788101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health