Provider Demographics
NPI:1235510157
Name:OTT, ALYSSA CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:CHRISTINE
Last Name:OTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 S QUEEN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3961
Mailing Address - Country:US
Mailing Address - Phone:410-440-9953
Mailing Address - Fax:
Practice Address - Street 1:1224 S QUEEN ST STE 206
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3961
Practice Address - Country:US
Practice Address - Phone:410-440-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131406104100000X
PACW0196701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker