Active NPI
Etienne Elise Scott, PHD
- Psychologist
- New York, NY
National Provider Identifier
1649541004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 011155-1
- Practice address
- 149 E 78TH St
New York, NY 10075-0405 - Phone
- (212) 879-4900
- NPI assigned
- Jan 17, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 011155-1 | NY | Primary |
Addresses
Primary practice location
149 E 78TH St
New York, NY 10075-0405
Mailing address
184 17TH St
Brooklyn, NY 11215-5309
Phone (347) 228-4960
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011155-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326758400000",
"number": "1649541004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 17TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112155309",
"telephone_number": "347-228-4960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 E 78TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100750405",
"telephone_number": "212-879-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "ETIENNE",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-17",
"last_updated": "2012-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "011155-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.