Otto Johann Arnoscht, PH.D.

Individual provider Active NPI Clinical Psychologist · Wetumpka, AL

NPI 1407075153 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1407075153
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
0425 (AL)
Practice address
45 Cedar Ridge Dr
Wetumpka, AL 36093-3828
Phone
(334) 399-9115
Fax
(866) 614-8582
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20101020000188 AL Practitioner - Clinical Psychologist 4385651421 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0425ALMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Psychology, Inc Clinical Current
since Nov 12, 2002
Accepting new patients

Locations

7755 4th Ave S
Birmingham, AL 35206
Phone (205) 833-0146

2257 Taylor Rd
Ste 200
Montgomery, AL 36117
Phone (334) 270-9914

1736 Taliaferro Trl
Montgomery, AL 36117
Phone (334) 270-9000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0425 AL Yes

Addresses

Primary practice location

45 Cedar Ridge Dr
Wetumpka, AL 36093-3828

Mailing address

45 Cedar Ridge Dr
Wetumpka, AL 36093-3828
Phone (334) 399-9115

Other identifiers

IdentifierTypeStateIssuer
51516955ARNOtherALBLUE CROSS BLUE SHIELD OF

Other providers in Wetumpka, AL

All providers in Wetumpka, AL · Clinical Psychologist in Alabama

Sources for this page

Verify at the official NPI Registry.