Provider Demographics
NPI:1326270315
Name:PADILLA, SCOTT (PSYD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PADILLA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44121 HARRY BYRD HWY
Mailing Address - Street 2:SUITE 275
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5667
Mailing Address - Country:US
Mailing Address - Phone:703-895-9379
Mailing Address - Fax:
Practice Address - Street 1:44121 HARRY BYRD HWY
Practice Address - Street 2:SUITE 275
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5667
Practice Address - Country:US
Practice Address - Phone:703-895-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst