Healthcare Provider Details

I. General information

NPI: 1184633349
Provider Name (Legal Business Name): PATRICK ROSS SCOTT L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 N 11TH ST STE 100
LAS VEGAS NV
89101-3125
US

IV. Provider business mailing address

340 N 11TH ST STE 100
LAS VEGAS NV
89101-3125
US

V. Phone/Fax

Practice location:
  • Phone: 702-922-7015
  • Fax: 702-946-0866
Mailing address:
  • Phone: 702-922-7015
  • Fax: 702-946-0866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4910-C
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS17609
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: