Provider Demographics
NPI:1598050577
Name:SCOTT, CYNTHIA J (LCPC, MHRT-CSP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCPC, MHRT-CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1300
Mailing Address - Country:US
Mailing Address - Phone:207-454-0270
Mailing Address - Fax:207-454-0232
Practice Address - Street 1:127 PALMER ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619
Practice Address - Country:US
Practice Address - Phone:207-454-0270
Practice Address - Fax:207-454-0232
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103850000Medicaid