Provider Demographics
NPI:1972240992
Name:OTERO, JADE ANDREA (MHC)
Entity Type:Individual
Prefix:MRS
First Name:JADE
Middle Name:ANDREA
Last Name:OTERO
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 E 56TH ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3624
Mailing Address - Country:US
Mailing Address - Phone:818-339-5164
Mailing Address - Fax:
Practice Address - Street 1:140 E 56TH ST APT 3F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3624
Practice Address - Country:US
Practice Address - Phone:818-339-5164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health