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NPI Code Detail

MEDICARE: MR. SCOTT HUDSON SPAW MA, LPC-S, LCCA

MEDICARE: MR. SCOTT HUDSON SPAW MA, LPC-S, LCCA
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
1101YP2500XProfessional Counselor63607TX

General Provider Information

NPI Number : 1508199878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT HUDSON SPAW MA, LPC-S, LCCA
Provider Business Mailing Address
First Line : 7719 WOOD HOLLOW DR STE 201
Second Line :
City : AUSTIN
State : TX
Zip : 78731-1634
Country : US
Telephone Number : 512-658-8385
Fax Number :
Provider Business Practice Location Address
First Line : 7719 WOOD HOLLOW DR STE 201
Second Line :
City : AUSTIN
State : TX
Zip : 78731-1634
Country : US
Telephone Number : 512-658-8385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2009
Last Update Date : 01/12/2024

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