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OTTENBREIT PSYCHOTHERAPY ASSOCIATES LLC NPI 1639621857


NPI Information

NPI: 1639621857
Provider Name: OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
835 MASON ST
B-200
DEARBORN, MI
ZIP 48124
Phone: (313) 575-6297
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OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC is a clinical social worker in Dearborn, MI. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC NPI is 1639621857. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

835 MASON ST
B-200
DEARBORN, MI
ZIP 48124-231
Phone: (313) 575-6297
Fax: (313) 406-4617

The provider's authorized official is Bruce D. Ottenbreit .
The authorized official title is Clinical Social Worker and has the following contact phone number (313) 575-6297.

The enumeration date for this NPI number is 11/4/2016 and was last updated on 12/5/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalMSW-6801007603MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
112313056OTHERQAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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