Provider Demographics
NPI:1679020879
Name:COTTON, VANESSA RACHAEL (LMSW)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:RACHAEL
Last Name:COTTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COLUMBUS AVE
Mailing Address - Street 2:#10E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1400
Mailing Address - Country:US
Mailing Address - Phone:860-823-9855
Mailing Address - Fax:
Practice Address - Street 1:600 COLUMBUS AVE
Practice Address - Street 2:#10E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1400
Practice Address - Country:US
Practice Address - Phone:860-823-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool