Theresa N Otu, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5157-125 Issued in WI

Practice address

10117 74TH St
Suite 100
Kenosha, WI 53142-7533

Phone

(262) 697-8268

NPI assigned

Jan 10, 2012

Last updated

Aug 31, 2013By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Independent Physicians of Wisconsin, LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1871975920
  Medicare reassignment NPD
• Independent Physicians of Wisconsin, LLC

  • Durable Medical Equipment & Medical Supplies
  • Kenosha, WI
  • NPI 1588255996
  NPD

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377907200000",
    "number": "1770853574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7252 91ST AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531428253",
            "telephone_number": "502-412-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 74TH ST",
            "address_2": "SUITE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427533",
            "telephone_number": "262-697-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTU",
        "first_name": "THERESA",
        "middle_name": "N",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2013-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5157-125",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "KY-1567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Ann Ortiz, MS, OTR/L
• Paula Michelle Osgood, CRNA
• Emily Otero, APSW
• Ryan Otto
• Suzanne K Otto, DENTAL HYGENIST
• Our Future Prenatal LLC
• Becka Owens
• Chyvia L Owens
• Ingrid Owens, RN
• Olivia Owens, SAC-IT

• Professional Counselor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.