Provider Demographics
NPI:1801232970
Name:DR. BERNARD SCOTT PSYCHOTHERAPY INC.
Entity Type:Organization
Organization Name:DR. BERNARD SCOTT PSYCHOTHERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PSYD
Authorized Official - Phone:617-543-0655
Mailing Address - Street 1:198 HIGHLAND STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119
Mailing Address - Country:US
Mailing Address - Phone:617-543-0655
Mailing Address - Fax:617-442-5895
Practice Address - Street 1:198 HIGHLAND ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1444
Practice Address - Country:US
Practice Address - Phone:617-543-0655
Practice Address - Fax:617-442-5895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center