Provider Demographics
NPI:1558426270
Name:COTTEN, TIMOTHY DEAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:DEAN
Last Name:COTTEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1662
Mailing Address - Country:US
Mailing Address - Phone:903-838-3711
Mailing Address - Fax:903-838-8879
Practice Address - Street 1:5425 PLAZA DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1662
Practice Address - Country:US
Practice Address - Phone:903-838-3711
Practice Address - Fax:903-838-8879
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13043101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor