Healthcare Provider Details

I. General information

NPI: 1457947129
Provider Name (Legal Business Name): THERESA SCOTT, PSY.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 09/06/2023
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 MCCORMICK RD STE LL10
HUNT VALLEY MD
21031-1002
US

IV. Provider business mailing address

8 WILLIAM CT
SPARKS GLENCOE MD
21152-9400
US

V. Phone/Fax

Practice location:
  • Phone: 410-525-5333
  • Fax: 410-403-2833
Mailing address:
  • Phone: 717-955-1952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. THERESA MARIE SCOTT
Title or Position: LICENSED PSYCHOLOGIST/OWNER
Credential: PSY.D.
Phone: 717-965-1952