Provider Demographics
NPI:1700049962
Name:STROUD, COTINA HOUSTON (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:COTINA
Middle Name:HOUSTON
Last Name:STROUD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 WINDY MILL CT
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:GA
Mailing Address - Zip Code:30179-5437
Mailing Address - Country:US
Mailing Address - Phone:256-282-8548
Mailing Address - Fax:256-282-8548
Practice Address - Street 1:805 WINDY MILL CT
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:GA
Practice Address - Zip Code:30179-5437
Practice Address - Country:US
Practice Address - Phone:256-282-8548
Practice Address - Fax:256-282-8548
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1238A101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health