Ed Jay Scott, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.003173 Issued in IL

Practice address

201 E Morgan St
Jacksonville, IL 62650-2587

Phone

(217) 245-1655

Fax

(217) 245-4742

NPI assigned

Aug 23, 2012

Last updated

Aug 23, 2012By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Park Place Center

  • Clinical Social Worker
  • Jacksonville, IL
  • NPI 1346451853
  Authorized official Same address or phone

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

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1972851905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MORGAN ST",
            "address_2": "P.O. BOX 1304",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62651",
            "telephone_number": "217-245-1655",
            "fax_number": "217-245-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E MORGAN ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502587",
            "telephone_number": "217-245-1655",
            "fax_number": "217-245-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ED",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-23",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.003173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl P Schippel, D.C.
• Barbara K Schnepper, LPN
• Alexandra Schroeder
• Kaitlin Schulte
• Kris Alan Schwiderski, A.T.,C.
• Nancy J Scott
• Anthony Scroggins, D.P.M.
• Elizabeth Huss Secrist, LCPC
• Sterling Shafer, MD
• Sharshon Pharmacy Inc (Medicine Shoppe Pharmacy)

• Clinical Social Worker in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.

Verify at the official NPI Registry.