Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Olusola Carlton Olawale

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1205327764

Olusola Carlton Olawale is a Nurse Practitioner in Hampton, Georgia. Qualified in 2018, 8 years ago. Practices with Oconee Community Service Board, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
8
Licensed in
GA
In the registry since
2018
Specialties on file
3
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Practice location Address checks out

1684 Thorn Ridge Trl
Hampton, GA 30228
Phone: (614) 599-3617
Fax: (877) 779-5837
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence RN201539 (GA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence RN201539 (GA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence RN201539 (GA)

Record details

NPI number1205327764
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 21, 2018
Last updated in NPPESMay 5, 2021
Certification dateMay 5, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Oconee Community Service Board — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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