| Scott Community Care, Pllc | |
|
317 W 6th St Ste 208 Moscow ID 83843-2387 | |
| (208) 882-3504 | |
| (877) 935-2107 |
| Full Name | Scott Community Care, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 317 W 6th St Ste 208, Moscow, Idaho |
| Authorized Official Name and Position | Melanie Jayne Scott (OWNER) |
| Authorized Official Contact | 2088742962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Community Care, Pllc Po Box 307 Deary ID 83823-0307 Ph: (208) 877-1444 | Scott Community Care, Pllc 317 W 6th St Ste 208 Moscow ID 83843-2387 Ph: (208) 882-3504 |
| NPI Number | 1356644769 |
|---|---|
| Provider Enumeration Date | 12/08/2010 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Medicare PECOS PAC ID | 2567701618 |
|---|---|
| Medicare Enrollment ID | O20190306003704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356644769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Marti L Reese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841531605 PECOS PAC ID: 1153559174 Enrollment ID: I20140118000416 |
| Provider Name | Douglas P Salada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386919124 PECOS PAC ID: 5395067391 Enrollment ID: I20141202001364 |
| Provider Name | Kristine A Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629278197 PECOS PAC ID: 2163719501 Enrollment ID: I20160928001271 |
| Provider Name | Lennard P Zylstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407808728 PECOS PAC ID: 3072570514 Enrollment ID: I20190516001297 |
| Provider Name | Veronica Rose Mundell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043859515 PECOS PAC ID: 5496181067 Enrollment ID: I20200130002685 |
| Provider Name | Roxanne Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194064980 PECOS PAC ID: 4082066774 Enrollment ID: I20240118001124 |
| Provider Name | Jason Hooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770804320 PECOS PAC ID: 8224480926 Enrollment ID: I20240118001615 |
| Provider Name | Vanessa Matossian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669825451 PECOS PAC ID: 4385096122 Enrollment ID: I20240415002526 |
| Provider Name | Elizabeth Miles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356519870 PECOS PAC ID: 2264871607 Enrollment ID: I20240417002577 |
| Provider Name | Jennifer Wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356053409 PECOS PAC ID: 9830531318 Enrollment ID: I20240529003457 |
| Provider Name | Samantha Dingman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770369779 PECOS PAC ID: 3476995879 Enrollment ID: I20240530004126 |
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