Provider Demographics
NPI:1215236658
Name:SCOGIN, JEFFREY TRAVIS (MA, LCPC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:TRAVIS
Last Name:SCOGIN
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1626
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-1626
Mailing Address - Country:US
Mailing Address - Phone:406-253-1609
Mailing Address - Fax:
Practice Address - Street 1:1125 7TH ST
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2846
Practice Address - Country:US
Practice Address - Phone:406-253-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1551101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional