Individual provider · Type 1 NPI

Shannon Wallace Ottens, LCSW

Clinical Social Worker · Sebastopol, CA

NPI number 1740064229 Active

Practice location

652 Petaluma Ave Ste H
Sebastopol, CA 95472-4266

Call (707) 823-3166 Map

Mailing address

PO Box 8531
Santa Rosa, CA 95407-1531

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X139066 (CA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1740064229

Shannon Wallace Ottens, LCSW's National Provider Identifier is 1740064229, issued on Aug 24, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Sebastopol, CA. The record was last updated on Jun 15, 2026.