Provider Demographics
NPI:1306184999
Name:HOTTMAN, MICHAEL (LPC, CSAC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:HOTTMAN
Suffix:
Gender:M
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12390 STARTING GATE WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-3003
Mailing Address - Country:US
Mailing Address - Phone:804-767-5710
Mailing Address - Fax:
Practice Address - Street 1:12390 STARTING GATE WAY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-3003
Practice Address - Country:US
Practice Address - Phone:804-767-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102683101YA0400X
VA0701005392101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)