MEDICARE: SCOTT COUNSELING SERVICES

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

General Provider Information

NPI Number	:	1790337947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	14817 DOLPHIN WAY
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-3081
Country	:	US
Telephone Number	:	301-257-0894
Fax Number	:

Provider Business Practice Location Address
First Line	:	4315 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2600
Country	:	US
Telephone Number	:	301-257-0894
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	NATEEKA DAINISE SCOTT
Credential	:	LCPC
Telephone Number	:	301-257-0894

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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