Provider Demographics
NPI:1477624195
Name:COTTLE, MARGY A (LCSW PHD)
Entity Type:Individual
Prefix:MS
First Name:MARGY
Middle Name:A
Last Name:COTTLE
Suffix:
Gender:F
Credentials:LCSW PHD
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:COTTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW PHD
Mailing Address - Street 1:740 FRONT ST
Mailing Address - Street 2:320
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060
Mailing Address - Country:US
Mailing Address - Phone:831-423-0576
Mailing Address - Fax:831-423-6559
Practice Address - Street 1:740 FRONT ST
Practice Address - Street 2:320
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-423-0576
Practice Address - Fax:831-423-6559
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 42471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical