Alicia Ottati, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.08275.MIL Issued in OH

Practice address

1685 Mulberry Woods CT
Vandalia, OH 45377-9501

Phone

(937) 367-1270

NPI assigned

Aug 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Doctor of Philosophy

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.

• Medoptions of Ohio LLC

  • Psychiatry Physician
  • Columbus, OH
  • NPI 1629428974

  Clinical

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  OH

  Medicare reassignment

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1174990972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8139 OLD TROY PIKE # 1046",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241067",
            "telephone_number": "512-910-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 MULBERRY WOODS CT",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453779501",
            "telephone_number": "937-367-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTATI",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39344",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005413",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.08275.MIL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://ottatipsychotherapy.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Simple Practice Client Portal allows clients and other professionals to securely communicate and/or exchange health information",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Files sized 50MB or less",
            "address_1": "1685 Mulberry Woods Ct",
            "city": "Vandalia",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453779501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Matthew Oconnor
• Shelby Lynn Oda, LMFT
• Noah Alexander Ogle, PT
• Ohio Pediatrics, Inc.
• Tiffany Marie Oriti, PHARMD
• Our Redemption, LLC
• Carter Ryan Palmer, B.S.
• Erica Paluf, PHARMD
• Alexis D Parks Myton, MD
• Lucy Patton, DPT

• Clinical Psychologist in Vandalia, OH
• Providers in Vandalia, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.