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NPI Code Detail

MEDICARE: ALYSSA NICOLE SCOTT PSYD

MEDICARE: ALYSSA NICOLE SCOTT PSYD
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
1103TC0700XClinical Psychologist3926TN

General Provider Information

NPI Number : 1457840324
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA NICOLE SCOTT PSYD
Provider Business Mailing Address
First Line : 2112 N ROAN ST STE 300
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2519
Country : US
Telephone Number : 865-588-3173
Fax Number : 865-244-3579
Provider Business Practice Location Address
First Line : 2112 N ROAN ST STE 300
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2519
Country : US
Telephone Number : 865-588-3173
Fax Number : 865-244-3579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2018
Last Update Date : 01/08/2026

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Directions to “ ALYSSA NICOLE SCOTT PSYD” Practice Location

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