Provider Demographics
NPI:1912615865
Name:AROGUNDADE, JAMAL ABIODUN
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:ABIODUN
Last Name:AROGUNDADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PENNSYLVANIA NW
Mailing Address - Street 2:SUITE 131
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:202-949-6649
Mailing Address - Fax:
Practice Address - Street 1:5507 KAREN ELAINE DR APT 1023
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4115
Practice Address - Country:US
Practice Address - Phone:301-503-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC200001792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional