Provider Demographics
NPI:1689814485
Name:OTEY-SCOTT, STACIE D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STACIE
Middle Name:D
Last Name:OTEY-SCOTT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2815
Mailing Address - Country:US
Mailing Address - Phone:757-533-2334
Mailing Address - Fax:757-994-1511
Practice Address - Street 1:5326 CENTER ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2815
Practice Address - Country:US
Practice Address - Phone:757-533-2334
Practice Address - Fax:757-994-1511
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherUSA MANAGED CARE
VA368853OtherANTHEM BEHAVIORAL HEALTH (GHENT FAMILY MEDICINE
VAPAROtherFIRST HEALTH COMMERICAL
VAPAROtherOPTIMA BEHAVIORAL HEALTH
VA440878OtherMANAGED HEALTH NETWORK/TRICARE
VAPAROtherAETNA
VAPAROtherVA PREMIER HEALTH
VA2731640OtherCIGNA BEHAVIORAL HEALTH
VAPAROtherMULTIPLAN
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCORVEL/CORCARE
VA1689814485Medicaid
VA368851OtherANTHEM BEHAVIORAL HEALTH (PORTSMOUTH FAMILY MEDICINE)
VAMIS 600566-849OtherMAGELLAN HEALTH SERVICES
VA2731640OtherCIGNA BEHAVIORAL HEALTH