Provider Demographics
NPI:1528040235
Name:TRUSCOTT, JAMES W (EDD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:TRUSCOTT
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MUNDY ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6830
Mailing Address - Country:US
Mailing Address - Phone:570-826-3993
Mailing Address - Fax:570-830-2091
Practice Address - Street 1:150 MUNDY ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6830
Practice Address - Country:US
Practice Address - Phone:570-826-3993
Practice Address - Fax:570-830-2091
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005909L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1084109OtherCIGNA BEHAVIORAL HLTH
199763OtherMHN, INC.
PA073688OtherFIRST PRIORITY HEALTH
4343440OtherAETNA
PATR637283OtherHIGHMARK BLUE SHIELD
4343440OtherAETNA