Provider Demographics
NPI:1356728158
Name:SCOTT, DAVID WILLIAM (LMFT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WILLIAM
Last Name:SCOTT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 E MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84029-2501
Mailing Address - Country:US
Mailing Address - Phone:435-228-4181
Mailing Address - Fax:801-931-2027
Practice Address - Street 1:822 E MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84029-2501
Practice Address - Country:US
Practice Address - Phone:435-248-2025
Practice Address - Fax:801-931-2027
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8813704-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist