Provider Demographics
NPI:1033428677
Name:MCGILL, SCOTT ANDREW (MED, CRC, LRC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:MCGILL
Suffix:
Gender:M
Credentials:MED, CRC, LRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 KNOLLS RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07403-1547
Mailing Address - Country:US
Mailing Address - Phone:973-641-2691
Mailing Address - Fax:
Practice Address - Street 1:45 KNOLLS RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07403-1547
Practice Address - Country:US
Practice Address - Phone:973-641-2691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RT00350600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional