Provider Demographics
NPI:1962442830
Name:OTTESON, JAMES CURTIS (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CURTIS
Last Name:OTTESON
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 1:4475 W WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILLS
Mailing Address - State:UT
Mailing Address - Zip Code:84062
Mailing Address - Country:US
Mailing Address - Phone:801-205-2744
Mailing Address - Fax:801-763-7651
Practice Address - Street 1:71 N 490 W
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2264
Practice Address - Country:US
Practice Address - Phone:801-763-7775
Practice Address - Fax:801-763-7651
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3406966004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional