Provider Demographics
NPI:1457108458
Name:COTTINGHAM, HEIDI MARIA (MSW, BSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIA
Last Name:COTTINGHAM
Suffix:
Gender:F
Credentials:MSW, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 36TH ST S APT A13
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7711
Mailing Address - Country:US
Mailing Address - Phone:612-618-7456
Mailing Address - Fax:
Practice Address - Street 1:1112 NODAK DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2333
Practice Address - Country:US
Practice Address - Phone:701-232-6224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6737104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker