Healthcare Provider Details

I. General information

NPI: 1215360995
Provider Name (Legal Business Name): MARLEY P COTE M.A., LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 CHARLES PL NW
LOS RANCHOS NM
87107-6222
US

IV. Provider business mailing address

PO BOX 6274
ALBUQUERQUE NM
87197-6274
US

V. Phone/Fax

Practice location:
  • Phone: 505-980-8883
  • Fax:
Mailing address:
  • Phone: 505-980-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0185641
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCCMH0185641
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: