Provider Demographics
NPI:1881255347
Name:OTTEY, ELNITA TOTARSHA (LCMHC)
Entity type:Individual
Prefix:
First Name:ELNITA
Middle Name:TOTARSHA
Last Name:OTTEY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2661 W ROOSEVELT BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-0453
Mailing Address - Country:US
Mailing Address - Phone:704-635-4985
Mailing Address - Fax:
Practice Address - Street 1:2661 W ROOSEVELT BLVD STE 207
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-0453
Practice Address - Country:US
Practice Address - Phone:704-635-4985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NC14819101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional