MEDICARE: JOANA DONASCIMENTO COTTO LCSW-S

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	101YM0800X	Mental Health Counselor	54187	TX

General Provider Information

NPI Number	:	1881461648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANA DONASCIMENTO COTTO LCSW-S

Provider Business Mailing Address
First Line	:	3929 KIMBALLDALE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75233-2902
Country	:	US
Telephone Number	:	972-333-9831
Fax Number	:

Provider Business Practice Location Address
First Line	:	3929 KIMBALLDALE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75233-2902
Country	:	US
Telephone Number	:	972-333-9831
Fax Number	:

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

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	12/11/2023

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