Provider Demographics
NPI:1922191527
Name:SCOTT, RAYMOND LLOYD (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LLOYD
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 1:4231 LACLEDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108
Mailing Address - Country:US
Mailing Address - Phone:314-561-2958
Mailing Address - Fax:314-289-9983
Practice Address - Street 1:4231 LACLEDE AVENUE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108
Practice Address - Country:US
Practice Address - Phone:314-561-2958
Practice Address - Fax:314-289-9983
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17363103TC0700X
MO2016016621103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical