Otl Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

748-03-002 Issued in VA

Legal business name

OTL COMMUNITY SERVICES

Doing business as

Good Neighbor Mental Health Support, Inc.

Practice address

9201 Arboretum Pkwy Ste 300
North Chesterfield, VA 23236-5407

Phone

(855) 355-7001

Fax

(804) 251-0989

NPI assigned

Jun 23, 2010

Organization subpart

No

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

Authorized official

Name

Hailey Mazzei

Title

Program Director

Phone

(804) 520-4600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Good Neighbor Mental Health Support, Inc. Doing business as

Locations

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1114238375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 ARBORETUM PKWY STE 300",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232365407",
            "telephone_number": "855-355-7001",
            "fax_number": "804-251-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 ARBORETUM PKWY STE 300",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232365407",
            "telephone_number": "855-355-7001",
            "fax_number": "804-251-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTL COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "MAZZEI",
        "authorized_official_first_name": "HAILEY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "804-520-4600"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "748-03-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF BEHAVIORAL HEALTH AND DISABILITY SERVICES",
            "identifier": "748-03-002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Neighbor Mental Health Support, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Orthovirginia, Inc
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• Magdalena Grace Otal
• Melisha Lanay Otero, LPC
• Marva Celestine Otey
• Otl Community Services (Good Neighbor Intensive In Home Services, Inc.)
• Otl Community Services (Good Neighbor Outpatient Services, Inc.)
• Otl Outpatient Services LLC
• Tori Donna Ottaviano, PT, DPT
• Trevor Dale Ottofaro, MD

• Community/Behavioral Health Agency in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.