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General NPI Number Information
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NPI Number | 1679871784
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Entity Type | Organization
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Legal Business Name | OTL COMMUNITY SERVICES
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Dates
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Enumeration Date | 03/14/2011
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 9201 ARBORETUM PKWY STE 300
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-5407
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Country | US
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Telephone | 855-355-7001
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Fax | 804-251-0989
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Provider Business Mailing Address
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Address Line | 9201 ARBORETUM PKWY STE 300
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-5407
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Country | US
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Telephone | 804-520-4600
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Fax | 833-525-0063
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Authorized Official
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Title or Position | CEO
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Name | ERICA GREENE
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Credential |
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Telephone | 513-884-8926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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