Healthcare Provider Details

I. General information

NPI: 1467332684
Provider Name (Legal Business Name): SCOTT BEVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8310 GLOBE DR APT 504
MADISON WI
53717-4206
US

IV. Provider business mailing address

8310 GLOBE DR APT 504
MADISON WI
53717-4206
US

V. Phone/Fax

Practice location:
  • Phone: 816-805-1289
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12041
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: