Provider Demographics
NPI:1972131837
Name:COTTON, NICHOLE (LCPC)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:COTTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:SELVIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:71 LESCANTZ DR
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2196
Mailing Address - Country:US
Mailing Address - Phone:406-672-2056
Mailing Address - Fax:
Practice Address - Street 1:18 CEDAR ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2308
Practice Address - Country:US
Practice Address - Phone:406-672-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-42784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional