Provider Demographics
NPI:1558016626
Name:COTTER, MATTHEW (LSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:COTTER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 5TH AVE STE 140M
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2654
Mailing Address - Country:US
Mailing Address - Phone:610-737-5797
Mailing Address - Fax:
Practice Address - Street 1:4415 5TH AVE STE 140M
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2654
Practice Address - Country:US
Practice Address - Phone:412-864-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138827104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker