Healthcare Provider Details

I. General information

NPI: 1033888029
Provider Name (Legal Business Name): TINEYA JANE COTTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CAMPUS BLVD
NEWTOWN SQUARE PA
19073-3245
US

IV. Provider business mailing address

5450 WISSAHICKON AVE APT A606
PHILADELPHIA PA
19144-5219
US

V. Phone/Fax

Practice location:
  • Phone: 484-424-6629
  • Fax:
Mailing address:
  • Phone: 347-645-6515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW027844
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: