MEDICARE: JENNIFER COTTINGHAM-COLLINS

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	1041C0700X	Clinical Social Worker	6801100395	MI

General Provider Information

NPI Number	:	1386184935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER COTTINGHAM-COLLINS

Provider Business Mailing Address
First Line	:	4065 SALADIN DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-6249
Country	:	US
Telephone Number	:	616-942-2081
Fax Number	:

Provider Business Practice Location Address
First Line	:	4065 E HILLS CT SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-6249
Country	:	US
Telephone Number	:	616-942-2081
Fax Number	:

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

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	03/02/2026

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