Provider Demographics
NPI:1346468097
Name:SCOTT, JUDY S (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:S
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 VIA ARROYO
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1318
Mailing Address - Country:US
Mailing Address - Phone:805-650-4826
Mailing Address - Fax:805-652-6512
Practice Address - Street 1:899 VIA ARROYO
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1318
Practice Address - Country:US
Practice Address - Phone:805-650-4826
Practice Address - Fax:805-652-6512
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 95771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SW9577Medicare ID - Type Unspecified