MEDICARE: MARTINA SCOTT MA, LPC

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	101YP2500X	Professional Counselor	2016031769	MO

General Provider Information

NPI Number	:	1831515956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTINA SCOTT MA, LPC

Provider Business Mailing Address
First Line	:	3309 S KINGSHIGHWAY BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-1101
Country	:	US
Telephone Number	:	314-206-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 GONZAGA LN
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-7221
Country	:	US
Telephone Number	:	314-598-1654
Fax Number	:

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

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	01/16/2026

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