Provider Demographics
NPI:1518046481
Name:COTTEN, BENNETT LITTLE (LCSW)
Entity Type:Individual
Prefix:
First Name:BENNETT
Middle Name:LITTLE
Last Name:COTTEN
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 1:3733 NATIONAL DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4865
Mailing Address - Country:US
Mailing Address - Phone:919-782-4699
Mailing Address - Fax:
Practice Address - Street 1:3733 NATIONAL DR
Practice Address - Street 2:SUITE 114
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4865
Practice Address - Country:US
Practice Address - Phone:919-782-4699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000191041C0700X
NC357106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC24678OtherBLUE CROSS BLUE SHIELD #