Provider Demographics
NPI:1942567581
Name:SCOTT, AMY CHRISTINE (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CHRISTINE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 COLUMBINE VILLAGE DR APT D
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-8366
Mailing Address - Country:US
Mailing Address - Phone:719-623-9135
Mailing Address - Fax:
Practice Address - Street 1:27400 STATE HWY. 67
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863
Practice Address - Country:US
Practice Address - Phone:719-623-9135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0103539OtherCOLORADO NLC REGISTRATION