Provider Demographics
NPI:1083623169
Name:COTTON, ELENA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:MARIE
Last Name:COTTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 G ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-6731
Mailing Address - Country:US
Mailing Address - Phone:253-351-9969
Mailing Address - Fax:253-351-9969
Practice Address - Street 1:1509 G ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6731
Practice Address - Country:US
Practice Address - Phone:253-351-9969
Practice Address - Fax:253-351-9969
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000051981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical