Provider Demographics
NPI:1295761591
Name:BADGETT, SCOTT A (PHD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:BADGETT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 FLINT AVE APT 122
Mailing Address - Street 2:
Mailing Address - City:WOLFFORTH
Mailing Address - State:TX
Mailing Address - Zip Code:79382-9777
Mailing Address - Country:US
Mailing Address - Phone:806-535-4418
Mailing Address - Fax:
Practice Address - Street 1:1502 FLINT AVE APT 122
Practice Address - Street 2:
Practice Address - City:WOLFFORTH
Practice Address - State:TX
Practice Address - Zip Code:79382-9777
Practice Address - Country:US
Practice Address - Phone:806-535-4418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32134103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0016KMOtherBC/BS
TX0016KMOtherBC/BS