Provider Demographics
NPI:1316168859
Name:ASEMOTA, ROBERT OSAYANDE (MS, LCAS,CCS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:OSAYANDE
Last Name:ASEMOTA
Suffix:
Gender:M
Credentials:MS, LCAS,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 KELLY PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-2609
Mailing Address - Country:US
Mailing Address - Phone:336-882-6859
Mailing Address - Fax:336-882-6850
Practice Address - Street 1:202 KELLY PL
Practice Address - Street 2:SUITE 101
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2609
Practice Address - Country:US
Practice Address - Phone:336-882-6859
Practice Address - Fax:336-882-6850
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC277 & 68101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)