Provider Demographics
NPI:1013255165
Name:COTTER, CAROLE (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:
Last Name:COTTER
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ALBERTA DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1268
Mailing Address - Country:US
Mailing Address - Phone:732-536-0137
Mailing Address - Fax:
Practice Address - Street 1:16 ALBERTA DR.
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746
Practice Address - Country:US
Practice Address - Phone:732-536-0137
Practice Address - Fax:732-536-1112
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001763001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC0668632OtherMEDICARE