Active NPI
Marc Cottrell
- Psychologist
- Lynnwood, WA
National Provider Identifier
1609945500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY1000981
- Practice address
- 4807 196TH St SW Ste 220
Lynnwood, WA 98036-6409 - Phone
- (425) 835-5878
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Psychologist | 103T00000X | PSY1000981 | DC | Primary |
Addresses
Primary practice location
4807 196TH St SW Ste 220
Lynnwood, WA 98036-6409
Mailing address
4631 N Paulina St Apt 308
Chicago, IL 60640-4597
Phone (206) 335-4127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RC00054529 | Other | WA | REGISTERED COUNSELOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1609945500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4631 N PAULINA ST APT 308",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404597",
"telephone_number": "206-335-4127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4807 196TH ST SW STE 220",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366409",
"telephone_number": "425-835-5878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTRELL",
"first_name": "MARC",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "DC",
"license": "PSY1000981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED COUNSELOR",
"identifier": "RC00054529",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.