Provider Demographics
NPI:1538624739
Name:GARTNER-SCOTT, THERESA (LCSW)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:GARTNER-SCOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:ANN
Other - Last Name:GARTNER-SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3901 E 10TH ST APT E
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5466
Mailing Address - Country:US
Mailing Address - Phone:805-758-3407
Mailing Address - Fax:
Practice Address - Street 1:229 S DALE AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-2006
Practice Address - Country:US
Practice Address - Phone:714-654-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
851241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty