Provider Demographics
NPI:1083745798
Name:COTHAM, NANCY KATHLEEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KATHLEEN
Last Name:COTHAM
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 1:12 ANTLER PL
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6304
Mailing Address - Country:US
Mailing Address - Phone:831-657-1366
Mailing Address - Fax:831-657-1378
Practice Address - Street 1:2150 GARDEN RD STE B1
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5327
Practice Address - Country:US
Practice Address - Phone:831-657-1366
Practice Address - Fax:831-657-1378
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS135641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical