Active NPI
Tracie Ottman, MA, LPCA
- Counseling Psychologist
- Richardson, TX
National Provider Identifier
1821476573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 90507
- Practice address
- 1121 Hampshire LN Ste 100
Richardson, TX 75080-4306 - Phone
- (469) 367-6785
- NPI assigned
- May 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Counseling Psychologist | 103TC1900X | 90507 | TX | Primary |
| Counselor | 101Y00000X | A15044 | NC |
Addresses
Primary practice location
1121 Hampshire LN Ste 100
Richardson, TX 75080-4306
Mailing address
500 Fairway Dr
Ste 102
Deerfield Beach, FL 33441-1814
Other practice location 1
500 Fairway Dr
Ste 102
Deerfield Beach, FL 33441-1814
Phone (888) 880-9270
Other practice location 2
547 Keisler Dr Ste 104
Cary, NC 27518-9309
Phone (770) 853-0747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A15044 | NC | MD | Counselor |
| 90507 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1821476573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 FAIRWAY DR",
"address_2": "STE 102",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334411814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 HAMPSHIRE LN STE 100",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750804306",
"telephone_number": "469-367-6785"
}
],
"practiceLocations": [
{
"address_1": "500 Fairway Dr",
"address_2": "Ste 102",
"address_purpose": "LOCATION",
"city": "Deerfield Beach",
"state": "FL",
"postal_code": "334411814",
"country_code": "US",
"telephone_number": "888-880-9270",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "547 Keisler Dr Ste 104",
"address_purpose": "LOCATION",
"city": "Cary",
"state": "NC",
"postal_code": "275189309",
"country_code": "US",
"telephone_number": "770-853-0747",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OTTMAN",
"first_name": "TRACIE",
"credential": "MA, LPCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-14",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "90507",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "A15044",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.