Ottenbreit Psychotherapy Associates, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MSW-6801007603 Issued in MI

Legal business name

OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC

Practice address

835 Mason St
B-200
Dearborn, MI 48124-2231

Phone

(313) 575-6297

Fax

(313) 406-4617

NPI assigned

Nov 4, 2016

Last updated

Dec 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bruce D. Ottenbreit, LMSW, ASCWNPI 1912215443

Title

Clinical Social Worker

Phone

(313) 575-6297

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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.

• Bruce Dennis Ottenbreit, LMSW

  • Clinical Social Worker
  • Dearborn, MI
  • NPI 1912215443
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1639621857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 MASON ST",
            "address_2": "B-200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242231",
            "telephone_number": "313-575-6297",
            "fax_number": "313-406-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MASON ST",
            "address_2": "B-200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242231",
            "telephone_number": "313-575-6297",
            "fax_number": "313-406-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "OTTENBREIT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "313-575-6297",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW, ASCW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "MSW-6801007603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QAQH",
            "identifier": "12313056",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Osteoporosis Treatment Centers of America, PC
• Udoka Osuoha
• Eduardo Jose Otero-Loperena, MD
• Reem Othman
• Jessica L Ott, CPNP-PC
• Bruce Dennis Ottenbreit, LMSW
• Otto Bock Patient Care, LLC
• Hassan Sami Oueis, DDS
• Hayam Oustah
• Alex Ouza

• Clinical Social Worker in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.