Provider Demographics
NPI:1750628012
Name:PATTON-SCOTT, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PATTON-SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 WOODMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2743
Mailing Address - Country:US
Mailing Address - Phone:240-459-8442
Mailing Address - Fax:
Practice Address - Street 1:8120 WOODMONT AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2743
Practice Address - Country:US
Practice Address - Phone:240-459-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6133101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional