Shawna Otis, MS, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2469 Issued in NH

Practice address

25 Sundial Ave Ste 310W
Manchester, NH 03103-7244

Phone

(603) 634-9471

Fax

(603) 676-2173

NPI assigned

May 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jtsj1 Enterprises LLC

  • Mental Health Counselor
  • Manchester, NH
  • NPI 1801589759
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1104515394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SUNDIAL AVE STE 310W",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031037244",
            "telephone_number": "603-634-9471",
            "fax_number": "603-676-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SUNDIAL AVE STE 310W",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031037244",
            "telephone_number": "603-634-9471",
            "fax_number": "603-676-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "SHAWNA",
        "credential": "MS, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ostrouch
• Catherine Osuban, RN
• Maria Veronica Osullivan, MD
• Jill Ann Oswald, N.P.
• Teresa Maria Oszkinis, MD
• Steven Gerard Ottariano, RPH
• Dena Otto
• Mayonet Ou
• Rene Ouellet, LICSW
• Anna Ouellette, OTR/L

• Mental Health Counselor in Manchester, NH
• Providers in Manchester, NH by specialty
• Mental Health Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.