Provider Demographics
NPI:1376394395
Name:COTNER, JOSHUA J (PLADC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:J
Last Name:COTNER
Suffix:
Gender:M
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 BOXELDER DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2807
Mailing Address - Country:US
Mailing Address - Phone:402-310-7837
Mailing Address - Fax:
Practice Address - Street 1:721 K ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2949
Practice Address - Country:US
Practice Address - Phone:402-310-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2045101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)