Organization Active NPI

Lisa M. Ott, LCSW-C, LLC

  • Community/Behavioral Health Agency
  • Columbia, MD
National Provider Identifier
1396217741
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LISA M. OTT, LCSW-C, LLC
Practice address
8640 Guilford Rd Ste 252
Columbia, MD 21046-2666
Phone
(410) 440-5828
Fax
(410) 312-7298
NPI assigned
Dec 26, 2018
Last updated
Dec 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Authorized official

Name
Ms. Lisa M Ott, MSW, LCSW-CNPI 1336509033
Title
Owner
Phone
(410) 440-5828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

8640 Guilford Rd Ste 252
Columbia, MD 21046-2666

Mailing address

9643 Green Moon Path
Columbia, MD 21046-2069
Phone (410) 440-5828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211103003050 MD Part B Supplier - Clinic/Group Practice 0749678183 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

8640 Guilford Rd
Ste 252
Columbia, MD 21046
Phone (410) 312-7250

8640 Guilford Rd
Ste 254
Columbia, MD 21046
Phone (410) 440-5828

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545782400000",
    "number": "1396217741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9643 GREEN MOON PATH",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462069",
            "telephone_number": "410-440-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 GUILFORD RD STE 252",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462666",
            "telephone_number": "410-440-5828",
            "fax_number": "410-312-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M. OTT, LCSW-C, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-440-5828",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.