Provider Demographics
NPI:1073891636
Name:JACQUELINE B. SCHOTT, LCSW, LLC
Entity Type:Organization
Organization Name:JACQUELINE B. SCHOTT, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:225-788-1339
Mailing Address - Street 1:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-1054
Mailing Address - Country:US
Mailing Address - Phone:225-788-1339
Mailing Address - Fax:
Practice Address - Street 1:4787 WAYWOOD DR
Practice Address - Street 2:SUITE C
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2480
Practice Address - Country:US
Practice Address - Phone:225-788-1339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA43661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty