Active NPI
Maurice Antoine Scott
- Counselor
- Charlotte, NC
National Provider Identifier
1205487162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 20806
- Practice address
- 3705 Latrobe Dr Ste 340
Charlotte, NC 28211-4823 - Phone
- (704) 618-1004
- NPI assigned
- Sep 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 20806 | NC | Primary |
Addresses
Primary practice location
3705 Latrobe Dr Ste 340
Charlotte, NC 28211-4823
Mailing address
2233 Clonmel PL
Charlotte, NC 28262-2502
Phone (704) 618-1004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20806 | NC | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1205487162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2233 CLONMEL PL",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282622502",
"telephone_number": "704-618-1004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3705 LATROBE DR STE 340",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282114823",
"telephone_number": "704-618-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "MAURICE",
"middle_name": "ANTOINE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-23",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": "NC",
"license": "20806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.