Provider Demographics
NPI:1023207438
Name:PARENT, SCOTT S (MHRT-C & LADC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:S
Last Name:PARENT
Suffix:
Gender:M
Credentials:MHRT-C & LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NH
Mailing Address - Zip Code:03584-3508
Mailing Address - Country:US
Mailing Address - Phone:603-788-5029
Mailing Address - Fax:603-788-5607
Practice Address - Street 1:7 PAGE HILL RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-3531
Practice Address - Country:US
Practice Address - Phone:603-342-5000
Practice Address - Fax:603-752-6062
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC4049101YA0400X
101Y00000X
MELC4848101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103850000OtherMAINECARE
ME1023207438Medicaid