Scot McKenzie
Individual provider Active NPI Pastoral Counselor · Java, VA
NPI 1407319643 · NPPES record last updated Apr 12, 2019
Key facts
- NPI
- 1407319643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pastoral Counselor 101YP1600X
- Practice address
- 725 Corner Rd
Java, VA 24565-4704 - Phone
- (434) 835-4930
- NPI assigned
- Apr 12, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | VA | Yes |
Addresses
Primary practice location
725 Corner Rd
Java, VA 24565-4704
Mailing address
725 Corner Rd
Java, VA 24565-4704
Phone (434) 835-4930
Other providers in Java, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.