Provider Demographics
NPI:1700342961
Name:SCOTT, MICHAEL S (MS, CRC, CVE)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MS, CRC, CVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12298 INGLESIDE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24739-4590
Mailing Address - Country:US
Mailing Address - Phone:304-661-9550
Mailing Address - Fax:
Practice Address - Street 1:12298 INGLESIDE RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24739-4590
Practice Address - Country:US
Practice Address - Phone:304-661-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor