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General NPI Number Information
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NPI Number | 1497146690
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Entity Type | Individual
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Provider Name | SCOTT TEMPLE LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 199 NM HIGHWAY 50
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City | PECOS
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State | NM
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Zip | 87552
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Country | US
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Telephone | 505-757-6482
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Fax |
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Provider Business Mailing Address
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Address Line | 44 SETON VILLAGE RD
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City | SANTA FE
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State | NM
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Zip | 87508-8153
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Country | US
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Telephone | 505-699-5261
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Fax |
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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 | C-08994
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License Number State | NM
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