Provider Demographics
NPI:1558005942
Name:FLEMING, SCOTT ALEXANDER (MDIV, MS, NCC, HEC-C)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALEXANDER
Last Name:FLEMING
Suffix:
Gender:
Credentials:MDIV, MS, NCC, HEC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 770277
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34777-0277
Mailing Address - Country:US
Mailing Address - Phone:407-947-1179
Mailing Address - Fax:
Practice Address - Street 1:213 S DILLARD ST STE 120B
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3596
Practice Address - Country:US
Practice Address - Phone:407-734-3338
Practice Address - Fax:407-734-3338
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23907101YM0800X
101Y00000X, 101YP1600X, 101YP2500X
00092565174V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No174V00000XOther Service ProvidersClinical Ethicist