Provider Demographics
NPI:1831873686
Name:SCOTT, MICHAELA (BCBA)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 CONNECTICUT AVE NW APT 211
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-3482
Mailing Address - Country:US
Mailing Address - Phone:630-373-6646
Mailing Address - Fax:
Practice Address - Street 1:1440 N ST NW STE A1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-2817
Practice Address - Country:US
Practice Address - Phone:630-373-6646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1-23-65901103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst