Provider Demographics
NPI:1609065119
Name:SCOTT, REBECCA Q (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:Q
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:J
Other - Last Name:QUATTRUCCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:223 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4852
Mailing Address - Country:US
Mailing Address - Phone:646-558-0800
Mailing Address - Fax:
Practice Address - Street 1:724 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2710
Practice Address - Country:US
Practice Address - Phone:646-558-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-20
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016614-1103TB0200X
NY016614103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral