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General NPI Number Information
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NPI Number | 1992241525
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Entity Type | Individual
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Provider Name | VATARA SCOTT LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 12/10/2022
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Provider Practice Location Address
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Address Line | 3735 JUNCTION BLVD
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City | RALEIGH
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State | NC
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Zip | 27603-5263
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Country | US
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Telephone | 919-946-1373
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Fax |
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Provider Business Mailing Address
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Address Line | 500 BENSON RD # 238
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City | GARNER
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State | NC
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Zip | 27529-3947
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Country | US
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Telephone | 919-583-6627
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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 | C011877
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License Number State | NC
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