Provider Demographics
NPI:1629322474
Name:SCOTT, JEAN WEEKLEY (PHD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:WEEKLEY
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11331 CHASE RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-9587
Mailing Address - Country:US
Mailing Address - Phone:740-707-5400
Mailing Address - Fax:
Practice Address - Street 1:310 W UNION ST STE 102
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2312
Practice Address - Country:US
Practice Address - Phone:740-331-6918
Practice Address - Fax:740-571-4280
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6474103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1063486058OtherNPI
OH9320392Medicare PIN