TINA SUE OTTO LPC CADC NPI 1891813465

NPI Information

NPI: 1891813465
Provider Name: TINA SUE OTTO, LPC, CADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
421 W MAIN ST
VANDALIA, IL
ZIP 62471
Phone: (618) 283-4229
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Tina Sue Otto, LPC, CADC is an addiction (substance use disorder) counselor in Vandalia, IL. Tina Sue Otto, LPC, CADC NPI is 1891813465. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

421 W MAIN ST
VANDALIA, IL
ZIP 62471-214
Phone: (618) 283-4229

The enumeration date for this NPI number is 3/26/2007 and was last updated on 5/5/2009.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	178.006052	ILLINOIS	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	17890	ILLINOIS	Yes

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: 5/5/2024

NPI Synchronization or Removal

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