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NPI Code Detail

MEDICARE: THOMAS REGINALD SANDER SCOTT LCSWA

MEDICARE: THOMAS REGINALD SANDER SCOTT LCSWA
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
11041C0700XClinical Social WorkerP014836NC

General Provider Information

NPI Number : 1437760485
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS REGINALD SANDER SCOTT LCSWA
Provider Business Mailing Address
First Line : 932 LYSTRA LN
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27517-7731
Country : US
Telephone Number : 919-932-0857
Fax Number :
Provider Business Practice Location Address
First Line : 2732 ANN ELIZABETH DR
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-6650
Country : US
Telephone Number : 336-229-5905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2020
Last Update Date : 08/13/2020

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