MEDICARE: KATELYN BROOKE SCOTT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.2506295	OH

General Provider Information

NPI Number	:	1033775960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN BROOKE SCOTT

Provider Business Mailing Address
First Line	:	6678 KENNEDY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-1163
Country	:	US
Telephone Number	:	765-914-0353
Fax Number	:

Provider Business Practice Location Address
First Line	:	8300 PRINCETON GLENDALE RD STE 201
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1677
Country	:	US
Telephone Number	:	513-201-7528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	01/12/2026

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