Provider Demographics
NPI:1457774978
Name:OTTE, KAREN (MSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:OTTE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NEW HAVEN RD.
Mailing Address - Street 2:PO BOX 236
Mailing Address - City:DURHAM
Mailing Address - State:CT
Mailing Address - Zip Code:06422
Mailing Address - Country:US
Mailing Address - Phone:860-349-3631
Mailing Address - Fax:
Practice Address - Street 1:525 NEW HAVEN RD.
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CT
Practice Address - Zip Code:06422-0236
Practice Address - Country:US
Practice Address - Phone:860-349-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0403771041C0700X
CT0008081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical