Provider Demographics
NPI:1912393067
Name:EMMERSON-PACE, SCOTT (MS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:EMMERSON-PACE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KNOLLWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1126
Mailing Address - Country:US
Mailing Address - Phone:203-445-3291
Mailing Address - Fax:
Practice Address - Street 1:19 KNOLLWOOD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1126
Practice Address - Country:US
Practice Address - Phone:203-445-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health