Provider Demographics
NPI:1912240250
Name:MONSON, SCOTT B (MDIV, LADC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:B
Last Name:MONSON
Suffix:
Gender:M
Credentials:MDIV, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 7TH PL E
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2148
Mailing Address - Country:US
Mailing Address - Phone:651-266-2992
Mailing Address - Fax:651-266-2982
Practice Address - Street 1:121 7TH PL E
Practice Address - Street 2:SUITE 2500
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2148
Practice Address - Country:US
Practice Address - Phone:651-266-2992
Practice Address - Fax:651-266-2982
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303491101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)