Provider Demographics
NPI:1003243874
Name:SCOTT, SHEENA (LPCA)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14766 STATE HIGHWAY 194 W
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-5416
Mailing Address - Country:US
Mailing Address - Phone:606-216-5189
Mailing Address - Fax:
Practice Address - Street 1:14766 STATE HIGHWAY 194 W
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-5416
Practice Address - Country:US
Practice Address - Phone:606-216-5189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10681041C0700X
KY128325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY270795565Medicaid