MEDICARE: SCOTT INNES

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
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1275899643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT INNES

Provider Business Mailing Address
First Line	:	680 S OAK DR
Second Line	:
City	:	WOODLAND HILLS
State	:	UT
Zip	:	84653-2039
Country	:	US
Telephone Number	:	801-857-5899
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 S OAK DR
Second Line	:
City	:	WOODLAND HILLS
State	:	UT
Zip	:	84653-2039
Country	:	US
Telephone Number	:	801-857-5899
Fax Number	:

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

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	02/28/2023

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Directions to “ SCOTT INNES ” Practice Location

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