Basic Information
| Provider Information | |||||||||
| NPI: | 1790864650 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALAO | ||||||||
| FirstName: | ADEJOKE | ||||||||
| MiddleName: | ADENRELE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11059 E BETHANY DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800142622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036172818 | ||||||||
| FaxNumber: | 3036172562 | ||||||||
| Practice Location | |||||||||
| Address1: | 1290 CHAMBERS RD | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800117117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036172818 | ||||||||
| FaxNumber: | 3036172562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 992281 | CO | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | CSW.00992281 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 10776044 | 05 | CO | MEDICAID |