Provider Demographics
NPI:1831316496
Name:SCOTT, FREDERICK M (LMHC)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4625
Mailing Address - Country:US
Mailing Address - Phone:845-343-7060
Mailing Address - Fax:
Practice Address - Street 1:2139 ROUTE 17K
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549
Practice Address - Country:US
Practice Address - Phone:845-361-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002672-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health