Provider Demographics
NPI:1437195583
Name:SCALES, MISCHCA TAPSCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:MISCHCA
Middle Name:TAPSCOTT
Last Name:SCALES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:MISCHCA
Other - Middle Name:JANAYE
Other - Last Name:TAPSCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7417 TURNBUOY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-4333
Mailing Address - Country:US
Mailing Address - Phone:512-507-6342
Mailing Address - Fax:512-531-9271
Practice Address - Street 1:441 HIGHWAY 71 W
Practice Address - Street 2:A
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3931
Practice Address - Country:US
Practice Address - Phone:512-507-6342
Practice Address - Fax:512-531-9271
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-1559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX600663363OtherBLUE CROSS BLUE SHIELD TEXAS
TX161254101Medicaid
TX8B1713Medicare ID - Type Unspecified