=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033909643
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIA COTTINGHAM LGPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2025
-----------------------------------------------------
Last Update Date | 05/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 540 RIVERSIDE DR STE 15
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21801-5352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-358-6904
-----------------------------------------------------
Fax | 855-975-2477
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 540 RIVERSIDE DR STE 15
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21801-5352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-358-6904
-----------------------------------------------------
Fax | 855-975-2477
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LGP16337
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------