Provider Demographics
NPI:1104162718
Name:COTUGNO, MICHELLE C (LMHC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:C
Last Name:COTUGNO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-1407
Mailing Address - Country:US
Mailing Address - Phone:413-736-0286
Mailing Address - Fax:
Practice Address - Street 1:205 ROCKY HILL RD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4050
Practice Address - Country:US
Practice Address - Phone:413-584-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7390101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor