Provider Demographics
NPI:1386199131
Name:SOULE, ADEOLA MAISHA (LCSW)
Entity type:Individual
Prefix:MS
First Name:ADEOLA
Middle Name:MAISHA
Last Name:SOULE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ADEOLA
Other - Middle Name:MAISHA
Other - Last Name:ADELABU-SOULE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-515-2300
Mailing Address - Fax:
Practice Address - Street 1:264 LANDIS AVE # 100
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2627
Practice Address - Country:US
Practice Address - Phone:619-906-5383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA973501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical