Healthcare Provider Details

I. General information

NPI: 1881011815
Provider Name (Legal Business Name): JOSEPH R SCOTTI PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 HIGH ST STE 716 WHOLE FAMILIES / WHOLE VETERANS, PLLC
MORGANTOWN WV
26505-5448
US

IV. Provider business mailing address

PO BOX 197 WHOLE FAMILIES / WHOLE VETERANS, PLLC
MORGANTOWN WV
26507-0197
US

V. Phone/Fax

Practice location:
  • Phone: 304-906-9087
  • Fax: 304-212-7379
Mailing address:
  • Phone: 304-906-9087
  • Fax: 304-212-7379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number532
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPS004475L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number532
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS004475L
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS004475L
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number532
License Number StateWV
# 7
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS004475L
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number532
License Number StateWV
# 9
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPS004475L
License Number StatePA
# 10
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number532
License Number StateWV

VIII. Authorized Official

Name: JOSEPH ROBERT SCOTTI
Title or Position: CLINICAL PSYCHOLOGIST / BCBA-D
Credential: PHD
Phone: 304-906-9087