Matthew Nicholas Otto, TCADC
NPI 1053907634ActiveIndividual· Counselor· Lexington, KY
Counselor (TCADC) with Roaring Brook LLC, practicing in Lexington, Kentucky. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1053907634 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | TCADC |
| Sole proprietor | No |
| NPI issued | Dec 17, 2020 |
| Last updated in NPPES | Jun 24, 2024 |
| Certified by provider | Jun 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X | 290511 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (KY) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Roaring Brook LLCLexington, KY · 5 clinicians
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