Healthcare Provider Details

I. General information

NPI: 1891737029
Provider Name (Legal Business Name): SCOTT P. ANSTADT LSCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E 15TH ST
HAYS KS
67601-3632
US

IV. Provider business mailing address

114 E 15TH ST
HAYS KS
67601-3632
US

V. Phone/Fax

Practice location:
  • Phone: 785-408-9611
  • Fax:
Mailing address:
  • Phone: 785-408-9611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRAODAC 137
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLISAC-10175
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSCSW 3660
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-10218
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: