Provider Demographics
NPI:1912037441
Name:OTTINGER, RICHARD ESTES JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ESTES
Last Name:OTTINGER
Suffix:JR
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 1:6730 CROSSVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-3452
Mailing Address - Country:US
Mailing Address - Phone:770-886-6153
Mailing Address - Fax:
Practice Address - Street 1:2550 NORTHWINDS PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-2241
Practice Address - Country:US
Practice Address - Phone:180-042-4541
Practice Address - Fax:678-319-3900
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002914101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional