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General NPI Number Information
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NPI Number | 1144262312
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Entity Type | Individual
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Provider Name | DOMINIC LEONARD SCOTTO LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 WOODLAND DR
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-3438
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Country | US
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Telephone | 908-216-2067
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Fax | 209-885-6448
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Provider Business Mailing Address
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Address Line | 2 WHITMAN CT
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City | FREEHOLD
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State | NJ
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Zip | 07728-4331
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Country | US
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Telephone | 732-780-0410
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Fax | 120-988-5644
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC00363500
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License Number State | NJ
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