Healthcare Provider Details

I. General information

NPI: 1902420128
Provider Name (Legal Business Name): COURTNEY COTTER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W CHERRY ST FL 2
SUNBURY OH
43074-3575
US

IV. Provider business mailing address

801 W CHERRY ST FL 2
SUNBURY OH
43074-3575
US

V. Phone/Fax

Practice location:
  • Phone: 203-293-8554
  • Fax:
Mailing address:
  • Phone: 614-214-2744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: