Provider Demographics
NPI:1942572235
Name:COTTER, SANDRA A (LCMHC, MLADC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:A
Last Name:COTTER
Suffix:
Gender:F
Credentials:LCMHC, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL CT
Mailing Address - Street 2:
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101-1489
Mailing Address - Country:US
Mailing Address - Phone:802-463-1292
Mailing Address - Fax:802-463-9588
Practice Address - Street 1:1 HOSPITAL CT
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101-1489
Practice Address - Country:US
Practice Address - Phone:802-463-1292
Practice Address - Fax:802-463-9588
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000443101YA0400X
VT0680069447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)