Jeffery Alan Patee Cotta, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LW30106946 Issued in WA

Practice address

205 8TH St
Hoquiam, WA 98550-2507

Phone

(360) 764-5762

NPI assigned

Dec 28, 2009

Last updated

Jun 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifeline Connections

  • Community/Behavioral Health Agency
  • Aberdeen, WA
  • NPI 1639719743
  NPD
• Contra Costa County

  dba Contra Costa Health

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD (past)
• Jerry Yasuda,O.D. Inc.

  • Optometrist
  • Visalia, CA
  • NPI 1780940981
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1922338896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1164",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985861164",
            "telephone_number": "564-888-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 8TH ST",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "985502507",
            "telephone_number": "360-764-5762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 E Tulare Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932923629",
            "country_code": "US",
            "telephone_number": "559-623-0900",
            "fax_number": "559-730-9937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTTA",
        "first_name": "JEFFERY",
        "middle_name": "ALAN PATEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-28",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW30106946",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 25359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60106946",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922338896",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922338896",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192233896",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacotta@bhr.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "205 8th St",
            "city": "Hoquiam",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985502507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• City of Hoquiam (Hoquiam City Jail)
• City of Hoquiam
• Michael Clark
• Cheryl Lynn Conklin, RN
• Cheryl Jean Conner, LPN
• Sarah Lisa Couture, CPC
• Crown Drug of Hoquiam Inc
• Jared Michael Cullifer, BHS, MOT, OTR/L
• Ralph Johannes Curry, OT
• Paulette Lynn Daniels, LPN

• Social Worker in Hoquiam, WA
• Providers in Hoquiam, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.