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NPI Code Detail

MEDICARE: CASSANDRA OTERO MA, LPCA

MEDICARE: CASSANDRA OTERO MA, LPCA
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
1101YM0800XMental Health CounselorA15415NC

General Provider Information

NPI Number : 1285272773
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA OTERO MA, LPCA
Provider Business Mailing Address
First Line : PO BOX 105
Second Line :
City : WHITSETT
State : NC
Zip : 27377-0105
Country : US
Telephone Number : 919-590-3586
Fax Number : 336-585-7522
Provider Business Practice Location Address
First Line : 1205 S MAIN ST
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-5762
Country : US
Telephone Number : 919-590-3586
Fax Number : 336-585-7522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2019
Last Update Date : 12/15/2019

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