Provider Demographics
NPI:1194860411
Name:SCOGGIN, STEVEN N (LPC, PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:N
Last Name:SCOGGIN
Suffix:
Gender:M
Credentials:LPC, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W 1ST ST STE 410
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-4225
Mailing Address - Country:US
Mailing Address - Phone:336-716-7578
Mailing Address - Fax:336-716-7337
Practice Address - Street 1:2000 W 1ST ST STE 410
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-4225
Practice Address - Country:US
Practice Address - Phone:336-716-7578
Practice Address - Fax:336-716-7337
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC189996OtherMEDCOST
NC128RNOtherBCBSNC