Provider Demographics
NPI:1992732515
Name:SCOTTI, JOSEPH ROBERT (PHD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROBERT
Last Name:SCOTTI
Suffix:
Gender:M
Credentials:PHD
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 197
Mailing Address - Street 2:WHOLE FAMILIES / WHOLE VETERANS, PLLC
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-0197
Mailing Address - Country:US
Mailing Address - Phone:304-906-9087
Mailing Address - Fax:304-212-7379
Practice Address - Street 1:235 HIGH ST STE 716
Practice Address - Street 2:WHOLE FAMILIES / WHOLE VETERANS, PLLC
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5448
Practice Address - Country:US
Practice Address - Phone:304-906-9087
Practice Address - Fax:304-212-7379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV532103TC0700X, 103K00000X, 103TB0200X, 103TC2200X, 103TM1800X
PAPS004475L103TC0700X, 103K00000X, 103TB0200X, 103TC2200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQ463830281OtherMEDICARE PROVIDER TRANSACTION ACCESS NUMBER