Healthcare Provider Details

I. General information

NPI: 1730907288
Provider Name (Legal Business Name): DANIELLE SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 JOHN R RD
TROY MI
48083-2512
US

IV. Provider business mailing address

18504 WOODBINE
FRASER MI
48026-2104
US

V. Phone/Fax

Practice location:
  • Phone: 586-268-4160
  • Fax:
Mailing address:
  • Phone: 586-872-7840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: