Provider Demographics
NPI:1962834044
Name:SCOTT, GRACE HARRIETT (MED)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:HARRIETT
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:HARRIETT
Other - Last Name:SHIPPENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52 ELDER RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2415
Mailing Address - Country:US
Mailing Address - Phone:339-225-0986
Mailing Address - Fax:
Practice Address - Street 1:555 AMORY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2652
Practice Address - Country:US
Practice Address - Phone:339-225-0986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health