MEDICARE: KARLA Y COTA LPC-24008

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-24008	AZ
2	101YM0800X	Mental Health Counselor	5583	NH

General Provider Information

NPI Number	:	1306462429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA Y COTA LPC-24008

Provider Business Mailing Address
First Line	:	700 MASSACHUSETTS AVE FL 3
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-3345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 N CENTRAL AVE STE M43
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2309
Country	:	US
Telephone Number	:	888-500-2067
Fax Number	:	617-649-8520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2020
Last Update Date	:	03/16/2026

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