Scott E Wellborn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06035200 Issued in NJ

Practice address

10000 Midlantic Dr
Mount Laurel, NJ 08054-1520

Phone

(732) 982-2888

NPI assigned

Dec 1, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• PHC of Buffalo Grove Clinical Psychology

  dba Portrait Health Centers

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1467057224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KNIGHTSWOOD DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532522",
            "telephone_number": "856-793-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 MIDLANTIC DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541520",
            "telephone_number": "732-982-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLBORN",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06035200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbra M Webb, CF-SLP
• Marisa Latanya Wedderburn
• Wegmans Food Markets, Inc. (Wegmans Pharmacy #008)
• Simin Wei, BCBA
• Lisa Weissbach-Efrat, LSW
• Wellsprings Holistic Medicine LLC
• Becky Wesley, LMFT
• West Therapeutic Consultation Services, LLC
• Clara West, DSW
• Lindsay Alexandra West, DO

• Clinical Social Worker in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.