Provider Demographics
NPI:1851673776
Name:SCOTT, JOSHUA STEWART (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:STEWART
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1571 YORK AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6049
Mailing Address - Country:US
Mailing Address - Phone:917-684-4511
Mailing Address - Fax:
Practice Address - Street 1:1571 YORK AVE APT 3N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6049
Practice Address - Country:US
Practice Address - Phone:917-684-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019187103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical