Provider Demographics
NPI:1356537518
Name:ADAMS, SCOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 E 9TH ST APT 6-0
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6302
Mailing Address - Country:US
Mailing Address - Phone:646-247-2976
Mailing Address - Fax:
Practice Address - Street 1:611 BROADWAY RM 629B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2650
Practice Address - Country:US
Practice Address - Phone:646-247-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY584007OtherVALUE OPTIONS
NY0153005OtherGHI