MEDICARE: SHAD SCOTT M.S.

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	101YP2500X	Professional Counselor	CP0234	NV

General Provider Information

NPI Number	:	1104224658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAD SCOTT M.S.

Provider Business Mailing Address
First Line	:	7341 W CHARLESTON BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1573
Country	:	US
Telephone Number	:	702-710-5729
Fax Number	:

Provider Business Practice Location Address
First Line	:	7341 W CHARLESTON BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1573
Country	:	US
Telephone Number	:	702-710-5729
Fax Number	:

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

Provider Enumeration Date	:	12/16/2014
Last Update Date	:	03/25/2026

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Directions to “ SHAD SCOTT M.S.” Practice Location

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