Shelly Rae Ottre, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C8833 Issued in OR

Practice address

880 S Main St
Lebanon, OR 97355-3210

Phone

(541) 933-5730

NPI assigned

Sep 19, 2024

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1295562510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30077 INGRAM RD",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973559506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 S MAIN ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553210",
            "telephone_number": "541-933-5730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30077 Ingram Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973559506",
            "country_code": "US",
            "telephone_number": "503-269-2549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTRE",
        "first_name": "SHELLY",
        "middle_name": "RAE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C8833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth L. Orwick, M.D.
• Kevin E Osborne, DMD
• Orin Levi Osborne, DMD
• Q Leslie Osborne, DMD
• Wyatt Edward Osborne
• Andrew Robert Owenreay, DO
• Lauren Alexandra Ozdowski
• Monica Jean Paden
• James Page, CADC II
• Nathan Palmer

• Professional Counselor in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.