MEDICARE: ANDREA M SCOTT LCSW

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	2690-S	NV
2	1041C0700X	Clinical Social Worker	5488-C	NV

General Provider Information

NPI Number	:	1780756874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA M SCOTT LCSW

Provider Business Mailing Address
First Line	:	6900 N PECOS RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-4400
Country	:	US
Telephone Number	:	702-960-6996
Fax Number	:	702-791-9386

Provider Business Practice Location Address
First Line	:	2775 S JONES BLVD
Second Line	:	STE. 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5631
Country	:	US
Telephone Number	:	702-685-3300
Fax Number	:	702-586-3333

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/08/2023

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