Provider Demographics
NPI:1528286663
Name:WILLIAM J SCOTT JR MS
Entity type:Organization
Organization Name:WILLIAM J SCOTT JR MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:570-283-2040
Mailing Address - Street 1:601 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3701
Mailing Address - Country:US
Mailing Address - Phone:570-283-2040
Mailing Address - Fax:570-280-2032
Practice Address - Street 1:601 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3701
Practice Address - Country:US
Practice Address - Phone:570-283-2040
Practice Address - Fax:570-280-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTIN