# RONALD OTWORI NP IN PSYCHIATRY PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Summit
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053150219
- **Authorized official:** RONALD OTWORI MS, NPP (OWNER)
- **Authorized official phone:** (518) 577-3640

## Contact information

- **Practice address:** 258 USHERS RD STE 203, CLIFTON PARK, NY 12065-1428
- **Practice address phone:** (518) 577-3640
- **Practice address fax:** (518) 776-1050
- **Mailing address:** 11 LANDMARK ST, LATHAM, NY 12110-2005
- **Mailing address phone:** (518) 577-3640
- **Mailing address fax:** (518) 776-1050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2024
- **Last updated:** 05/20/2024