Provider Demographics
NPI:1831335546
Name:OTT, RUTH ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:OTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 PARSONS ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4135
Mailing Address - Country:US
Mailing Address - Phone:775-293-2816
Mailing Address - Fax:
Practice Address - Street 1:819 RIVERVIEW AVE W # 4
Practice Address - Street 2:
Practice Address - City:ALDERSON
Practice Address - State:WV
Practice Address - Zip Code:24910-9618
Practice Address - Country:US
Practice Address - Phone:775-293-2816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health