Provider Demographics
NPI:1447747209
Name:GORNTO, SCOTT (MDIV, LMFT, CST)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:GORNTO
Suffix:
Gender:M
Credentials:MDIV, LMFT, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 CHAPEL HILL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8448
Mailing Address - Country:US
Mailing Address - Phone:469-396-7680
Mailing Address - Fax:
Practice Address - Street 1:6101 CHAPEL HILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8448
Practice Address - Country:US
Practice Address - Phone:972-312-8893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5152103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist