Provider Demographics
NPI:1174216022
Name:SCOTT, WESLEY DILLON
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:DILLON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12337 WINDSOR EAST DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3051
Mailing Address - Country:US
Mailing Address - Phone:812-225-1314
Mailing Address - Fax:
Practice Address - Street 1:23 SOUTH 8TH ST
Practice Address - Street 2:#1100 AND #1150
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060
Practice Address - Country:US
Practice Address - Phone:317-537-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health