Provider Demographics
NPI:1346793155
Name:SANDRA COTTER,LCMHC, LADC,LLC
Entity type:Organization
Organization Name:SANDRA COTTER,LCMHC, LADC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COTTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC,LADC
Authorized Official - Phone:603-558-4201
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:ALSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03602-0213
Mailing Address - Country:US
Mailing Address - Phone:603-558-4201
Mailing Address - Fax:
Practice Address - Street 1:18 THE SQ STE 10
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101-1380
Practice Address - Country:US
Practice Address - Phone:603-558-4201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000443101YA0400X
VT0680069447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty