Provider Demographics
NPI:1720069107
Name:HERSHMAN, SCOTT HARRIS (LCSW,LMFT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:HARRIS
Last Name:HERSHMAN
Suffix:
Gender:M
Credentials:LCSW,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 RIDGE TOP DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-3915
Mailing Address - Country:US
Mailing Address - Phone:915-759-9458
Mailing Address - Fax:
Practice Address - Street 1:5005 N PIEDRAS ST
Practice Address - Street 2:WBAMC/ATT CREDENTIALS
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-569-1382
Practice Address - Fax:915-569-1233
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001057A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical