Walter Scott, LSAA

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mescalero, NM

NPI 1326589623 · NPPES record last updated Mar 20, 2017

Key facts

NPI
1326589623
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
0175541 (NM)
Practice address
107 Sunset Loop
Mescalero, NM 88340-0228
Phone
(575) 464-4432
Fax
(575) 464-4431
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0175541NMMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mescalero Apache Tribe Past
since May 16, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0175541 NM Yes

Addresses

Primary practice location

107 Sunset Loop
Mescalero, NM 88340-0228

Mailing address

PO Box 228
Mescalero, NM 88340-0228
Phone (575) 464-4432

Other providers in Mescalero, NM

All providers in Mescalero, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.