Individual
OTIS LOCKETT, JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,LPC, CSAC, ICS,
Contact information
Practice address
230 W WELLS ST, SUITE 214, MILWAUKEE, WI 53203-1866
(414) 839-8994
(414) 291-6407
Mailing address
230 W WELLS ST, SUITE 214, MILWAUKEE, WI 53203-1866
(414) 839-8994
(414) 223-3817
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1661
WI
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39394200
—
WI
Enumeration date
07/18/2007
Last updated
10/10/2014
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