Provider Demographics
NPI:1316121643
Name:SCOTT A HOLZMAN, PHD. LLC
Entity type:Organization
Organization Name:SCOTT A HOLZMAN, PHD. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-997-8847
Mailing Address - Street 1:11055 LITTLE PATUXENT PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2896
Mailing Address - Country:US
Mailing Address - Phone:410-997-8847
Mailing Address - Fax:410-997-3809
Practice Address - Street 1:11055 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2896
Practice Address - Country:US
Practice Address - Phone:410-997-8847
Practice Address - Fax:410-997-3809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03200OtherSTATE LICENSE
MD565PMedicare PIN