Provider Demographics
NPI:1235746637
Name:SCOTT, DESIREE CHANTEL
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:CHANTEL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DESIREE
Other - Middle Name:CHANTEL
Other - Last Name:STILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA, SW-T
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1411
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-564-9296
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1411
Practice Address - Country:US
Practice Address - Phone:309-996-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.174315101YA0400X
OHS.2102052-TRNE104100000X
1041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical