Provider Demographics
NPI:1487725834
Name:SPAULDING, SCOTT ANDREW (MA PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:SPAULDING
Suffix:
Gender:M
Credentials:MA PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 SMITH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1314
Mailing Address - Country:US
Mailing Address - Phone:888-505-1862
Mailing Address - Fax:681-265-9250
Practice Address - Street 1:1116 SMITH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1314
Practice Address - Country:US
Practice Address - Phone:888-505-1862
Practice Address - Fax:681-265-9250
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV936103TC2200X, 103TF0000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily