Provider Demographics
NPI:1932676822
Name:LAIRD, SCOTT ALLEN
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALLEN
Last Name:LAIRD
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 1:8717 THUNDERBIRD CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5739
Mailing Address - Country:US
Mailing Address - Phone:720-233-8761
Mailing Address - Fax:
Practice Address - Street 1:8717 THUNDERBIRD CIR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5739
Practice Address - Country:US
Practice Address - Phone:720-233-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO101YM0800XMedicaid