Provider Demographics
NPI:1730529264
Name:DEILY, SCOTT (PMSW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:DEILY
Suffix:
Gender:M
Credentials:PMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4017
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-4017
Mailing Address - Country:US
Mailing Address - Phone:505-429-2991
Mailing Address - Fax:
Practice Address - Street 1:508 W. BROADWAY ST.
Practice Address - Street 2:SUITE E
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:505-429-2991
Practice Address - Fax:575-538-1035
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-099231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical