Provider Demographics
NPI:1598177388
Name:MOUSSEAU, SCOTT ANDREW
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:MOUSSEAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 WIMBLEDON XING
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-6320
Mailing Address - Country:US
Mailing Address - Phone:978-866-3159
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON ST STE 303
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4768
Practice Address - Country:US
Practice Address - Phone:781-843-3683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor