Provider Demographics
NPI:1649207697
Name:CAVINS, SCOTT ALEXANDER (MA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALEXANDER
Last Name:CAVINS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 CLEARVISTA PKWY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1661
Mailing Address - Country:US
Mailing Address - Phone:800-446-0305
Mailing Address - Fax:317-806-3867
Practice Address - Street 1:8102 CLEARVISTA PKWY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1661
Practice Address - Country:US
Practice Address - Phone:800-446-0305
Practice Address - Fax:317-806-3867
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000119A101YM0800X
IN35001332A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000276088OtherANTHEM/WELLPOINT BC/BS
IN172022OtherCOMPSYCH
IN0005468510OtherAETNA
76742982OtherUBH
IN114986000OtherMAGELLAN