Healthcare Provider Details

I. General information

NPI: 1942686985
Provider Name (Legal Business Name): SCOTT EMERSON LLOYD PH. D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 BROADWAY 17 FL
NEW YORK NY
10019-4640
US

IV. Provider business mailing address

1745 BROADWAY 17 FL
NEW YORK NY
10019-4640
US

V. Phone/Fax

Practice location:
  • Phone: 212-851-8102
  • Fax: 212-537-0102
Mailing address:
  • Phone: 212-851-8102
  • Fax: 212-537-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number021247
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number021247
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number021247
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number021247
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number021247
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number021247
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number021247
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number021247
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number021247
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number021247
License Number StateNY
# 11
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number021247
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: