Provider Demographics
NPI:1538278767
Name:OTTE, JAMES EDWARD (LPC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:OTTE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 SPARKFORD CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5514
Mailing Address - Country:US
Mailing Address - Phone:817-446-0526
Mailing Address - Fax:
Practice Address - Street 1:1800 WEST FWY
Practice Address - Street 2:SUITE D
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-5930
Practice Address - Country:US
Practice Address - Phone:972-741-9407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14394OtherL.P.C. LICENSE NUMBER