Provider Demographics
NPI:1881820827
Name:SCOTT, ANTHONY RASHAUN
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:RASHAUN
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6466 BRIGHT NIMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5341
Mailing Address - Country:US
Mailing Address - Phone:702-279-3644
Mailing Address - Fax:
Practice Address - Street 1:6466 BRIGHT NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-5341
Practice Address - Country:US
Practice Address - Phone:702-279-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507626Medicaid