Provider Demographics
NPI:1912357773
Name:ABBOTT, SCOTT (LMHC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:ABBOTT
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 1:506 5TH AVE # 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4812
Mailing Address - Country:US
Mailing Address - Phone:347-927-1155
Mailing Address - Fax:
Practice Address - Street 1:506 5TH AVE # 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4812
Practice Address - Country:US
Practice Address - Phone:347-927-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health