Individual
KEITH SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3754
(631) 920-8609
Mailing address
2 BLUFF ROAD, SAINT JAMES, NY 11780
(631) 880-2444
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30879
NY
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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