Candice Lynell Ott, BA BHRS – Counselor

Key facts

NPI: 1982954228
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
Practice address: 113 W Ada Ave
Wilburton, OK 74578-2416
Phone: (918) 297-3400
Fax: (918) 297-3401
NPI assigned: Sep 13, 2012
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Community Couselors Group Inc. Community/Behavioral Health Agency · McAlester, OK · NPI 1841574589

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Bachelor of Arts

Practice roles

Organization	Specialty	Status	New patients
Community Couselors Group Inc.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X			Yes

Addresses

Primary practice location

113 W Ada Ave
Wilburton, OK 74578-2416

Mailing address

113 W Ada Ave
Wilburton, OK 74578-2416
Phone (918) 297-3400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2012.

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1982954228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W ADA AVE",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745782416",
            "telephone_number": "918-297-3400",
            "fax_number": "918-297-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W ADA AVE",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745782416",
            "telephone_number": "918-297-3400",
            "fax_number": "918-297-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "CANDICE",
        "middle_name": "LYNELL",
        "credential": "BA BHRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilburton, OK

All providers in Wilburton, OK · Counselor in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.