Healthcare Provider Details

I. General information

NPI: 1902172182
Provider Name (Legal Business Name): LAURA J COTTRELL LCPC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2012
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 PASQUINELLI DR STE 204
WESTMONT IL
60559-1291
US

IV. Provider business mailing address

6809 WESTMORELAND DR
WOODRIDGE IL
60517-1611
US

V. Phone/Fax

Practice location:
  • Phone: 630-560-0136
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.008136
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180008136
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: