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Organization
OTL OUTPATIENT SERVICES LLC
Active
Organization
OTL OUTPATIENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RICHARDSON (CEO)
(804) 520-4600
Entity
Organization
Contact information
Practice address
9201 ARBORETUM PKWY STE 300, NORTH CHESTERFIELD, VA 23236-5407
(804) 520-4600
(833) 525-0063
Mailing address
9201 ARBORETUM PKWY STE 300, NORTH CHESTERFIELD, VA 23236-5407
(804) 520-4600
(833) 525-0063
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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