Provider Demographics
NPI:1609374073
Name:SCOTT, DANA M (LMSW)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W PATERSON ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-2581
Mailing Address - Country:US
Mailing Address - Phone:269-349-2641
Mailing Address - Fax:269-466-5522
Practice Address - Street 1:117 W PATERSON ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-2581
Practice Address - Country:US
Practice Address - Phone:269-349-2641
Practice Address - Fax:269-466-5522
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011043401041C0700X
MI68011102581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical