Provider Demographics
NPI:1477676872
Name:VOTAW, JAMES D (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:VOTAW
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MANSFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-2027
Mailing Address - Country:US
Mailing Address - Phone:860-456-2261
Mailing Address - Fax:860-779-5437
Practice Address - Street 1:132 MANSFIELD AVE
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2027
Practice Address - Country:US
Practice Address - Phone:860-456-2261
Practice Address - Fax:860-779-5437
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004040564Medicaid