Provider Demographics
NPI:1316643117
Name:COTTON, RACHEL B (LAC)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:B
Last Name:COTTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 BOOTHILL CT STE 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-7215
Mailing Address - Country:US
Mailing Address - Phone:406-406-5007
Mailing Address - Fax:406-565-5485
Practice Address - Street 1:22 W PARK ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1714
Practice Address - Country:US
Practice Address - Phone:406-565-5484
Practice Address - Fax:406-565-5485
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-71899101YA0400X
MT62319101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTACLC-LIC-62319Medicaid