Provider Demographics
NPI:1952671547
Name:MELANIE C. SCOTT, PSY.D., LLC
Entity Type:Organization
Organization Name:MELANIE C. SCOTT, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:860-325-0646
Mailing Address - Street 1:21 NEW BRITAIN AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1100
Mailing Address - Country:US
Mailing Address - Phone:860-325-0646
Mailing Address - Fax:203-842-3945
Practice Address - Street 1:300 GEORGE ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6624
Practice Address - Country:US
Practice Address - Phone:860-325-0646
Practice Address - Fax:203-842-3945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2996261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)