Healthcare Provider Details

I. General information

NPI: 1619431343
Provider Name (Legal Business Name): SCOTT E ALLEN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 SCIENCE DR STE 300
MADISON WI
53711-1064
US

IV. Provider business mailing address

304 N SEGOE RD UNIT 102
MADISON WI
53705-4600
US

V. Phone/Fax

Practice location:
  • Phone: 262-789-1191
  • Fax:
Mailing address:
  • Phone: 920-650-5868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10547-125
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10547
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: