Basic Information
| Provider Information | |||||||||
| NPI: | 1831774058 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCUTT | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 531 FARBER LAKES DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142215773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166325450 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 531 FARBER LAKES DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142215773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166325450 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2021 | ||||||||
| LastUpdateDate: | 10/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 011077 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.