Provider Demographics
NPI:1033470232
Name:LANDON, SCOTT CURTIS (LPC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:CURTIS
Last Name:LANDON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:CURTIS
Other - Last Name:LANDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:832 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:DEFOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-3073
Mailing Address - Country:US
Mailing Address - Phone:608-573-1165
Mailing Address - Fax:
Practice Address - Street 1:832 CLOVER LN
Practice Address - Street 2:
Practice Address - City:DEFOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-3073
Practice Address - Country:US
Practice Address - Phone:608-573-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4800-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional