Provider Demographics
NPI:1699314104
Name:LOTTO, COURTNEY (MSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:LOTTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E PINE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4542
Mailing Address - Country:US
Mailing Address - Phone:406-239-6805
Mailing Address - Fax:
Practice Address - Street 1:204 E PINE ST APT 4
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4542
Practice Address - Country:US
Practice Address - Phone:406-239-6805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT38905104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker