MEDICARE: KATARINA SCOTT MC, LAC

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	101YM0800X	Mental Health Counselor	15803

General Provider Information

NPI Number	:	1427560499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARINA SCOTT MC, LAC

Provider Business Mailing Address
First Line	:	2320 W PEORIA AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 W PEORIA AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4753
Country	:	US
Telephone Number	:	480-869-2618
Fax Number	:

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

Provider Enumeration Date	:	10/31/2017
Last Update Date	:	03/17/2018

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