Provider Demographics
NPI:1457935942
Name:COTENACIOUS THERAPY
Entity type:Organization
Organization Name:COTENACIOUS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:GROBICKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:443-305-9074
Mailing Address - Street 1:8865 STANFORD BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5422
Mailing Address - Country:US
Mailing Address - Phone:443-305-9074
Mailing Address - Fax:443-305-8812
Practice Address - Street 1:8865 STANFORD BLVD STE 202
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5422
Practice Address - Country:US
Practice Address - Phone:443-305-9074
Practice Address - Fax:443-305-8812
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COTENACIOUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-10
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1558744987OtherNPPES
1619560612OtherNPPES
1811342868OtherNPPES
1841893773OtherNPPES
1952954505OtherNPPES
1962110452OtherNPPES
1952573271OtherNPPES
1972173557OtherNPPES