Provider Demographics
NPI:1932819356
Name:KOMOLAFE, MORUFAT OLUSEUN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MORUFAT
Middle Name:OLUSEUN
Last Name:KOMOLAFE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SEUN
Other - Middle Name:
Other - Last Name:KOMOLAFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1009 JONATHAN CV
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-1130
Mailing Address - Country:US
Mailing Address - Phone:512-829-8285
Mailing Address - Fax:
Practice Address - Street 1:1009 JONATHAN CV
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-1130
Practice Address - Country:US
Practice Address - Phone:512-829-8285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty