Provider Demographics
NPI:1386261071
Name:COTTON, CASSANDRA L (MFT-INTERN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:L
Last Name:COTTON
Suffix:
Gender:F
Credentials:MFT-INTERN
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:L
Other - Last Name:COTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT-INTERN
Mailing Address - Street 1:522 SENECA RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1314
Mailing Address - Country:US
Mailing Address - Phone:702-303-4457
Mailing Address - Fax:
Practice Address - Street 1:522 SENECA RIDGE AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1314
Practice Address - Country:US
Practice Address - Phone:702-303-4457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional