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NPI Code Detail

MEDICARE: OLIVIA SCOTT

MEDICARE:   OLIVIA  SCOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorS1600468OH

General Provider Information

NPI Number : 1083066146
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA SCOTT
Provider Business Mailing Address
First Line : 202 E BAGLEY RD
Second Line :
City : BEREA
State : OH
Zip : 44017-2058
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5706 TURNEY RD STE 200
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-3928
Country : US
Telephone Number : 216-970-8714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2016
Last Update Date : 07/12/2016

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Directions to “ OLIVIA SCOTT ” Practice Location

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