Provider Demographics
NPI:1326213497
Name:COTTON, EMILY SUSAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUSAN
Last Name:COTTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:SUSAN
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:200 W ALONA LANE
Mailing Address - Street 2:UNIFIED COMMUNITY SERVICES
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813
Mailing Address - Country:US
Mailing Address - Phone:608-723-6357
Mailing Address - Fax:
Practice Address - Street 1:200 W ALONA LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-2202
Practice Address - Country:US
Practice Address - Phone:608-723-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7429-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43737100Medicaid