Jordan Otto, MA, ED.S

Individual provider Active NPI School Psychologist · Washington, DC

NPI 1992471429 · NPPES record last updated May 30, 2024

Key facts

NPI
1992471429
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
License
DC5894675568 (DC)
Practice address
1405 Brentwood Pkwy NE
Washington, DC 20002-2220
Phone
(202) 678-2527
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
DC5894675568DCMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth of Virginia State Board of Health Past
since Aug 1, 2021
Accepting new patients
James Madison University Past
since Aug 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
School Psychologist 103TS0200X DC5894675568 DC Yes

Addresses

Primary practice location

1405 Brentwood Pkwy NE
Washington, DC 20002-2220

Mailing address

416B Nicholson St
Charlottesville, VA 22901-3778

Other providers in Washington, DC

All providers in Washington, DC · School Psychologist in District of Columbia

Sources for this page

Verify at the official NPI Registry.