Healthcare Provider Details

I. General information

NPI: 1851831275
Provider Name (Legal Business Name): SCOTT PAUL OGURICK MS, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 PINE HILL RD UNIT 22E
THOMASTON CT
06787-1953
US

IV. Provider business mailing address

143 PINE HILL RD UNIT 22 E
THOMASTON CT
06787-1955
US

V. Phone/Fax

Practice location:
  • Phone: 860-484-3712
  • Fax:
Mailing address:
  • Phone: 203-841-8297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number003063
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: