Provider Demographics
NPI:1639307127
Name:VANHOOK, SCOTTIE JEFFERY (MSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTTIE
Middle Name:JEFFERY
Last Name:VANHOOK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-0655
Mailing Address - Country:US
Mailing Address - Phone:910-257-1156
Mailing Address - Fax:910-814-4245
Practice Address - Street 1:1995 US 421 N
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-7436
Practice Address - Country:US
Practice Address - Phone:910-257-1156
Practice Address - Fax:910-814-4245
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0020921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical