Provider Demographics
NPI:1558621797
Name:EILERS, SCOTT JASON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JASON
Last Name:EILERS
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 1:3255 WILLIAMS BLVD SW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-1900
Mailing Address - Country:US
Mailing Address - Phone:319-246-2240
Mailing Address - Fax:319-246-6098
Practice Address - Street 1:3255 WILLIAMS BLVD SW
Practice Address - Street 2:SUITE 2
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-1900
Practice Address - Country:US
Practice Address - Phone:319-246-2240
Practice Address - Fax:319-246-6098
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083131103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist