MEDICARE: OTTER AND ELM MENTAL HEALTH COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1134054885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OTTER AND ELM MENTAL HEALTH COUNSELING

Provider Business Mailing Address
First Line	:	14001 MACQUARIE DR
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-6370
Country	:	US
Telephone Number	:	512-909-2041
Fax Number	:

Provider Business Practice Location Address
First Line	:	11673 JOLLYVILLE RD STE 201
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-4211
Country	:	US
Telephone Number	:	512-909-2041
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EMILY BREEDLOVE
Credential	:	MM, MA, LPC
Telephone Number	:	512-909-2041

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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