Healthcare Provider Details

I. General information

NPI: 1013820034
Provider Name (Legal Business Name): WAYNE ANTHONY SCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 W 2ND ST
BOUND BROOK NJ
08805-1833
US

IV. Provider business mailing address

339 W 2ND ST
BOUND BROOK NJ
08805-1833
US

V. Phone/Fax

Practice location:
  • Phone: 732-356-1082
  • Fax:
Mailing address:
  • Phone: 732-356-1082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FA00067500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: