Provider Demographics
NPI:1144700964
Name:BRUTSCHE, SCOTT TAYLOR (LSW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:TAYLOR
Last Name:BRUTSCHE
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7514 FRAILEY ROAD
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089
Mailing Address - Country:US
Mailing Address - Phone:440-789-3477
Mailing Address - Fax:
Practice Address - Street 1:34 WOODLAWN
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857
Practice Address - Country:US
Practice Address - Phone:567-560-3584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor