Provider Demographics
NPI:1821757642
Name:MARQUARDT, SCOTT E (LPC-I)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:MARQUARDT
Suffix:
Gender:M
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W BELTLINE HWY STE 301
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4228
Mailing Address - Country:US
Mailing Address - Phone:608-515-5309
Mailing Address - Fax:
Practice Address - Street 1:2901 W BELTLINE HWY STE 301
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4228
Practice Address - Country:US
Practice Address - Phone:608-515-5309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7616-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional