Jessica Otis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8696808-3501 Issued in UT

Practice address

12971 S Shawnee Dr
Riverton, UT 84096-7805

Phone

(801) 910-5587

NPI assigned

Mar 31, 2014

Last updated

Feb 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Abc Case Management, Inc.

  • Case Management Agency
  • Riverton, UT
  • NPI 1831657709
  NPD
• Ocd Relief Clinic LLC

  • Mental Health Counselor
  • South Ogden, UT
  • NPI 1942174123
  NPD

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1396163002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12971 S SHAWNEE DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967805",
            "telephone_number": "801-910-5587",
            "fax_number": "801-206-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12971 S SHAWNEE DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967805",
            "telephone_number": "801-910-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-925",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "113051",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-36030",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8696808-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Aleen Orton
• Bryce Osborne, M.D.
• Jessica Anna Osos, MA, BCBA, LBA
• Joshua Kei Otani, MS
• Jessica Lorraine Otero, LCMHC
• Our House of Riverton (River Pointe Mangament)
• Rex A Outtrim, MD
• McKinsey Oveson, RDN
• Audrie Pace
• Jill Pace, LCSW

• Clinical Social Worker in Riverton, UT
• Providers in Riverton, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.