Provider Demographics
NPI:1700631785
Name:WILSON, SCOTT CURTIS (LPC, LCP)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:CURTIS
Last Name:WILSON
Suffix:
Gender:M
Credentials:LPC, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 EASTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2116
Mailing Address - Country:US
Mailing Address - Phone:316-253-1318
Mailing Address - Fax:
Practice Address - Street 1:1801 EASTSIDE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-2116
Practice Address - Country:US
Practice Address - Phone:316-253-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS071103TC0700X
CO13038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical