Provider Demographics
NPI:1255709390
Name:SCOBLINK, KATY JOANNA (MSC, LISAC)
Entity type:Individual
Prefix:MRS
First Name:KATY
Middle Name:JOANNA
Last Name:SCOBLINK
Suffix:
Gender:F
Credentials:MSC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 N DEERCLOVER LN
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-8668
Mailing Address - Country:US
Mailing Address - Phone:520-909-4425
Mailing Address - Fax:
Practice Address - Street 1:11915 N DEERCLOVER LN
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-8668
Practice Address - Country:US
Practice Address - Phone:520-909-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-07
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC - 11884101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)