Provider Demographics
NPI:1194080457
Name:CHASE, WILLIAM SCOTT II (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:CHASE
Suffix:II
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:203 GREENWOOD AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1409
Mailing Address - Country:US
Mailing Address - Phone:570-319-6441
Mailing Address - Fax:570-468-8895
Practice Address - Street 1:203 GREENWOOD AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1409
Practice Address - Country:US
Practice Address - Phone:570-319-6441
Practice Address - Fax:570-468-8895
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017120103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical