| Lisa Otto, Lcsw Llc | |
|
121 E Grand Ave Ste 209 Laramie WY 82070-3652 | |
| (307) 760-2517 | |
| Not Available |
| Full Name | Lisa Otto, Lcsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 121 E Grand Ave Ste 209, Laramie, Wyoming |
| Authorized Official Name and Position | Lisa Otto (CEO) |
| Authorized Official Contact | 3077602517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Otto, Lcsw Llc Po Box 982 Laramie WY 82073-0982 Ph: () - | Lisa Otto, Lcsw Llc 121 E Grand Ave Ste 209 Laramie WY 82070-3652 Ph: (307) 760-2517 |
| NPI Number | 1356923627 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/26/2021 |
| Certification Date | 04/26/2021 |
| Medicare PECOS PAC ID | 6709285661 |
|---|---|
| Medicare Enrollment ID | O20210525002954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356923627 | NPI | - | NPPES |
| 1851707574 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lisa Otto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851707574 PECOS PAC ID: 7214299841 Enrollment ID: I20180320001165 |
Cathedral Home For Children Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4989 N 3rd St, Laramie, WY 82072 Phone: 307-745-8997 | |
Pendley And Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1277 N 15th St, Laramie, WY 82072 Phone: 307-742-6222 | |
Ark Regional Services, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1150 N 3rd St, Laramie, WY 82072 Phone: 307-742-6641 Fax: 307-742-9203 | |
Overcomer Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 265 N 4th St, Laramie, WY 82072 Phone: 307-399-0791 | |
Cathedral Home For Children Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4989 N 3rd St, Laramie, WY 82072 Phone: 307-745-8997 Fax: 307-742-6146 | |
Integrative Well-being Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1622 Shield St, Laramie, WY 82072 Phone: 307-760-5450 | |
Aktos Analytics, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1465 N 4th St, Suite #119, Laramie, WY 82072 Phone: 307-721-0700 |