Provider Demographics
NPI:1811220205
Name:COTTRILL, JOSHUA (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:COTTRILL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17818 ROY ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2355
Mailing Address - Country:US
Mailing Address - Phone:708-476-8784
Mailing Address - Fax:
Practice Address - Street 1:3624 216TH ST
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2713
Practice Address - Country:US
Practice Address - Phone:219-794-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IL149.0155541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor