Provider Demographics
NPI:1376209650
Name:SCOTT, KHALIL NOAH
Entity type:Individual
Prefix:
First Name:KHALIL
Middle Name:NOAH
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 W CAVALCADE ST UNIT 8826
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77249-0116
Mailing Address - Country:US
Mailing Address - Phone:281-940-0808
Mailing Address - Fax:281-884-3127
Practice Address - Street 1:5444 WESTHEIMER RD STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5318
Practice Address - Country:US
Practice Address - Phone:832-478-4524
Practice Address - Fax:832-478-4525
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator