Provider Demographics
NPI:1326174541
Name:HOTTINGER, JAMES PETER (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PETER
Last Name:HOTTINGER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13734 VESTRY RD
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7529
Mailing Address - Country:US
Mailing Address - Phone:801-571-9803
Mailing Address - Fax:801-571-9803
Practice Address - Street 1:4505 WASATCH BLVD
Practice Address - Street 2:S.320
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4709
Practice Address - Country:US
Practice Address - Phone:801-274-3800
Practice Address - Fax:801-277-8800
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT123130-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical