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NPI 1033620380

NPI 1033620380 : CHERYL K COTTRELL LPC : CHARLOTTESVILLE, VA

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General NPI Number Information
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    NPI Number           |    1033620380
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    Entity Type          |    Individual 
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    Provider Name        |    CHERYL K COTTRELL LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/13/2017
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    Last Update Date     |    10/13/2017
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Provider Practice Location Address
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    Address Line         |    875 EAST RIO COURT 
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    City                 |    CHARLOTTESVILLE
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    State                |    VA
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    Zip                  |    22901
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    Country              |    US
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    Telephone            |    434-963-0334
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    834 HARRIS RD 
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    City                 |    CHARLOTTESVILLE
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    State                |    VA
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    Zip                  |    22902-6467
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    Country              |    US
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    Telephone            |    434-987-2826
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    0701005619
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    License Number State |    VA
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