Provider Demographics
NPI:1861885899
Name:SCOTT, STEPHEN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 5TH AVE
Mailing Address - Street 2:APY 301
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1848
Mailing Address - Country:US
Mailing Address - Phone:917-577-5439
Mailing Address - Fax:
Practice Address - Street 1:811 5TH AVE
Practice Address - Street 2:APY 301
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1848
Practice Address - Country:US
Practice Address - Phone:917-577-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health