| Doctor Name: | MR. SCOTT DOUGLAS NORDSTROM |
| NPI Number: | 1154534147 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LCS 14899 |
| Business Practice Address: | 555 Hospital Ln Susanville, CA - 961304918 |
| Business Phone Number: | 5302518199 |
| Business Fax Number: | 5302512662 |
| Mailing Address: | 691-225 Las Plumas Way, SUSANVILLE |
| State: | CA |
| Postal Code: | 96130 |
| Phone Number: | 5302579321 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 12/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS 14899 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |