Provider Demographics
NPI:1861627101
Name:SCOTT, CHRISTINA ELIZABETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:ELIZABETH
Other - Last Name:GURGOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:120 W EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-3810
Mailing Address - Country:US
Mailing Address - Phone:716-858-8036
Mailing Address - Fax:
Practice Address - Street 1:120 W EAGLE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-3810
Practice Address - Country:US
Practice Address - Phone:716-858-8036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070046-1104100000X
NY088167-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker