Provider Demographics
NPI:1740562404
Name:DREW, SCOTT (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:DREW
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 KILEY PKWY UNIT 2404
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-6040
Mailing Address - Country:US
Mailing Address - Phone:775-297-6896
Mailing Address - Fax:775-324-9997
Practice Address - Street 1:520 MOUNT ROSE ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3362
Practice Address - Country:US
Practice Address - Phone:775-297-6896
Practice Address - Fax:775-324-9997
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMF 01111106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist