Laura Lynn Otto, LMHC, LPC, NCC, CCMH

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC006387 Issued in PA

Practice address

583 Skippack Pike Ste 410
Blue Bell, PA 19422-2146

Phone

(267) 405-6803

Fax

(267) 604-9091

NPI assigned

May 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Laura Lynn Deems Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Delaware County Professional Services, Inc

  dba LifeStance

  • Psychiatry Physician
  • Media, PA
  • NPI 1952485864
  NPD (past)

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1417182031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 SKIPPACK PIKE STE 410",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222146",
            "telephone_number": "267-405-6803",
            "fax_number": "267-604-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 SKIPPACK PIKE STE 410",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222146",
            "telephone_number": "267-405-6803",
            "fax_number": "267-604-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "LAURA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMHC, LPC, NCC, CCMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "004912",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC006387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "DEEMS",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "LMHC, LPC, NCC, CCMH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.