Provider Demographics
NPI:1316902992
Name:SCOTT, LEROY CHARLES JR (MS)
Entity type:Individual
Prefix:MR
First Name:LEROY
Middle Name:CHARLES
Last Name:SCOTT
Suffix:JR
Gender:M
Credentials:MS
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Mailing Address - Street 1:33 EAST NORTHAMPTON STREET
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-2492
Mailing Address - Country:US
Mailing Address - Phone:570-822-7118
Mailing Address - Fax:570-829-7781
Practice Address - Street 1:102 WARREN ST
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657
Practice Address - Country:US
Practice Address - Phone:570-836-1101
Practice Address - Fax:570-836-3765
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)