Active NPI
Nathan Otten, LPC
- Professional Counselor
- Fort Smith, AR
National Provider Identifier
1861646473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1602026
- Practice address
- 3111 S 70TH St
Fort Smith, AR 72903-5017 - Phone
- (479) 452-6650
- Fax
- (479) 452-5847
- NPI assigned
- Nov 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P1602026 | AR | Primary |
Addresses
Primary practice location
3111 S 70TH St
Fort Smith, AR 72903-5017
Mailing address
PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1602026 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1861646473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11818",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729171818",
"telephone_number": "479-452-6650",
"fax_number": "479-452-5847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 S 70TH ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729035017",
"telephone_number": "479-452-6650",
"fax_number": "479-452-5847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTEN",
"first_name": "NATHAN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-10",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1602026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.