Provider Demographics
NPI:1104995224
Name:MORSE, SCOTT KENNETH (LCSW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:KENNETH
Last Name:MORSE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5453
Mailing Address - Country:US
Mailing Address - Phone:207-329-4941
Mailing Address - Fax:207-761-5606
Practice Address - Street 1:609 MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5453
Practice Address - Country:US
Practice Address - Phone:207-329-4941
Practice Address - Fax:207-761-5606
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1C66371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2034293OtherCIGNA
276408OtherMHN
292702000OtherAETNA
292702000OtherMAGELLAN
022436OtherANTHEM
ME88101003Medicaid
ME88101003Medicaid