Judith A Otto, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

170-123 Issued in WI

Practice address

12630 W North Ave BLDG E
Brookfield, WI 53005

Phone

(262) 785-1008

Fax

(262) 432-9059

NPI assigned

Aug 1, 2006

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

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christian Life Counseling LLCGroup PAC ID 8325046162, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Christian Life Counseling LLC

  • Clinical Psychologist
  • Brookfield, WI
  • NPI 1659466860
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1982611265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 W NORTH AVE",
            "address_2": "BLDG E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054626",
            "telephone_number": "262-785-1008",
            "fax_number": "262-432-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 W NORTH AVE BLDG E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-785-1008",
            "fax_number": "262-432-9059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W175N11163 Stonewood Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "WI",
            "postal_code": "530226502",
            "country_code": "US",
            "telephone_number": "262-785-1008 x122",
            "fax_number": "262-432-9059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTO",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "170-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "170-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39624700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John M. Ostergaard, M.D.
• Paula Banser Osterhout, M.D.
• Otr Medical Associates
• Linda B. Otterbacher, PTA
• Abbigail Lynn Otto, OTR
• Nicholas Joseph Overbaugh, LPC
• Laura M Ozimek, PA-C
• Joheny R Pabon Rios, MS-LPC-IT
• Cameron Paddison, APNP
• Jill Paddock, OT

• Clinical Social Worker in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.