Provider Demographics
NPI:1679207724
Name:MCDOUGALL, SCOTT BLAISE (CHT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:BLAISE
Last Name:MCDOUGALL
Suffix:
Gender:M
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MINUTE MAN CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3271
Mailing Address - Country:US
Mailing Address - Phone:609-865-7332
Mailing Address - Fax:
Practice Address - Street 1:3 MINUTE MAN CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3271
Practice Address - Country:US
Practice Address - Phone:609-865-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor