Justin Ottis Mack, QMHS, CDCA is a
Case Manager/care Coordinator based in Garfield Heights, Ohio. Justin Ottis Mack is licensed to practice in Ohio (license number UH804004) and his current practice location is
12395 Mccracken Rd # Up, Garfield Heights, Ohio. He can be reached at his office (for appointments etc.) via phone at
(216) 587-6727.
NPI number for Justin Ottis Mack is 1508472952 and his current mailing address is 1370 West Blvd Apt 8, Cleveland, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508472952.
Healthcare Provider's Profile
Full Name | Justin Ottis Mack |
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Gender | Male |
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Speciality | Case Manager/care Coordinator |
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Location | 12395 Mccracken Rd # Up, Garfield Heights, Ohio |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1508472952
- Provider Enumeration Date: 09/21/2020
- Last Update Date: 02/07/2022
Medical Identifiers
Medical identifiers for Justin Ottis Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508472952 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 176595 (Ohio) | Secondary |
171M00000X | Case Manager/care Coordinator | UH804004 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Ottis Mack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Justin Ottis Mack, QMHS, CDCA 1370 West Blvd Apt 8, Cleveland, OH 44102-1737 Ph: (716) 446-3944 | Justin Ottis Mack, QMHS, CDCA 12395 Mccracken Rd # Up, Garfield Heights, OH 44125-2967 Ph: (216) 587-6727 |
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