Provider Demographics
NPI:1578669180
Name:SCOTT, LIONEL F (PHD)
Entity Type:Individual
Prefix:DR
First Name:LIONEL
Middle Name:F
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 BOYNTON AVE
Mailing Address - Street 2:#3D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:820 BOYNTON AVE
Practice Address - Street 2:#3D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4648
Practice Address - Country:US
Practice Address - Phone:718-328-3436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00124-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical