Provider Demographics
NPI:1366908766
Name:SCOTT, DARIAN L
Entity type:Individual
Prefix:
First Name:DARIAN
Middle Name:L
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 1:20800 CENTER RIDGE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-4306
Mailing Address - Country:US
Mailing Address - Phone:440-356-7620
Mailing Address - Fax:440-356-7623
Practice Address - Street 1:20800 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-4312
Practice Address - Country:US
Practice Address - Phone:440-356-7620
Practice Address - Fax:440-356-7623
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161091101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)