Healthcare Provider Details

I. General information

NPI: 1619668597
Provider Name (Legal Business Name): CHRISTOPHER MATTHEW SCOTT PH.D., LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 WEST PERIMETER ROAD
JOINT BASE ANDREWS MD
20762
US

IV. Provider business mailing address

1060 WEST PERIMETER ROAD
JOINT BASE ANDREWS MD
20762
US

V. Phone/Fax

Practice location:
  • Phone: 240-857-7186
  • Fax:
Mailing address:
  • Phone: 240-857-7186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13407734-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: