Provider Demographics
NPI:1083854616
Name:OTTER, CYNTHIA K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:K
Last Name:OTTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:K
Other - Last Name:OTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3800 GREENHOUSE RD
Mailing Address - Street 2:STE # 10
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7181
Mailing Address - Country:US
Mailing Address - Phone:281-636-6753
Mailing Address - Fax:832-301-4175
Practice Address - Street 1:3880 GREENHOUSE RD.
Practice Address - Street 2:STE #10
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7181
Practice Address - Country:US
Practice Address - Phone:281-636-6753
Practice Address - Fax:832-301-4175
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX550091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical