Healthcare Provider Details

I. General information

NPI: 1831375690
Provider Name (Legal Business Name): STEVEN MITCHELL SCOTT M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 PLEASANT RIDGE CIR
ROCK SPRING GA
30739-5002
US

IV. Provider business mailing address

206 PLEASANT RIDGE CIR
ROCK SPRING GA
30739-5002
US

V. Phone/Fax

Practice location:
  • Phone: 423-504-5875
  • Fax:
Mailing address:
  • Phone: 423-504-5875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC001854
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: