Provider Demographics
NPI:1437613304
Name:OTOLINSKY, JESSICA RAE (LCMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:OTOLINSKY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HINSON DR
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8568
Mailing Address - Country:US
Mailing Address - Phone:828-407-0784
Mailing Address - Fax:
Practice Address - Street 1:247 CHARLOTTE ST STE 203
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1468
Practice Address - Country:US
Practice Address - Phone:828-407-0784
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional