Wylie, Scott Devere
Wylie, Scott Devere is an individual health care provider with primary practice located at 113 Coronado Ct Suite 202, Fort Collins CO 80525-4911. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Health. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Wylie, Scott Devere can be contacted via phone (888) 666-0974.Contact Information
Primary practice address
113 Coronado Ct Suite 202
Fort Collins CO 80525-4911
Phone: (888) 666-0974
Fax: (970) 223-4433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 478 | Wyoming |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY18408 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 478 | Wyoming |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2962 | Colorado |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 2962 | Colorado |
| Behavioral Health & Social Service Providers / Health | 103TH0004X | 2962 | Colorado |
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 2962 | Colorado |
Profile Details
| NPI number | 1669497111 |
|---|---|
| LBN Legal business name | Wylie, Scott Devere |
| Credentials | PSY.D., MSCP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Apr 7th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669497111 | NPPES |
| Colorado | Other | 1629411319 | TYPE 2 NPI |
| Colorado | MEDICAID | 128459200 | TYPE 2 NPI |
| Colorado | MEDICAID | 1669497111 | TYPE 2 NPI |
| Colorado | Other | 462318597 | TYPE 2 NPI |
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