| Scott Therapeutic Services, Pllc | |
|
12840 S Ada St Calumet Park IL 60827-6410 | |
| (773) 875-5027 | |
| (773) 875-5027 |
| Full Name | Scott Therapeutic Services, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 12840 S Ada St, Calumet Park, Illinois |
| Authorized Official Name and Position | Leodis Scott (PRESIDENT) |
| Authorized Official Contact | 7738755027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Therapeutic Services, Pllc 12840 S Ada St Calumet Park IL 60827-6410 Ph: (773) 875-5027 | Scott Therapeutic Services, Pllc 12840 S Ada St Calumet Park IL 60827-6410 Ph: (773) 875-5027 |
| NPI Number | 1134915580 |
|---|---|
| Provider Enumeration Date | 04/15/2025 |
| Last Update Date | 09/02/2025 |
| Certification Date | 06/09/2025 |
| Medicare PECOS PAC ID | 1254841984 |
|---|---|
| Medicare Enrollment ID | O20250611000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134915580 | NPI | - | NPPES |
| Provider Name | Leodis F Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669844627 PECOS PAC ID: 2163932898 Enrollment ID: I20250611000898 |
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