Provider Demographics
NPI:1215281720
Name:DEHORTY, C. SCOTT (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:C.
Middle Name:SCOTT
Last Name:DEHORTY
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 ROLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2822
Mailing Address - Country:US
Mailing Address - Phone:443-617-5783
Mailing Address - Fax:
Practice Address - Street 1:220 EWING ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3806
Practice Address - Country:US
Practice Address - Phone:443-617-5783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical