Healthcare Provider Details

I. General information

NPI: 1417668989
Provider Name (Legal Business Name): ADRIANA SCOTT LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11815 FOUNTAIN WAY STE 300
NEWPORT NEWS VA
23606-4448
US

IV. Provider business mailing address

110 COLISEUM XING UNIT 6147
HAMPTON VA
23666-5971
US

V. Phone/Fax

Practice location:
  • Phone: 908-507-9532
  • Fax:
Mailing address:
  • Phone: 908-507-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200004853
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: