Healthcare Provider Details

I. General information

NPI: 1124950464
Provider Name (Legal Business Name): KEVIN FRANCIS SCOTT LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MICHAEL DR STE 109
SYOSSET NY
11791-5311
US

IV. Provider business mailing address

125 MICHAEL DR STE 109
SYOSSET NY
11791-5311
US

V. Phone/Fax

Practice location:
  • Phone: 631-292-0048
  • Fax:
Mailing address:
  • Phone: 631-292-0048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number016623
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: