Provider Demographics
NPI:1073910188
Name:SCOTT, ROBERTA (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 WARM SPRINGS RD STE 127
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-5668
Mailing Address - Country:US
Mailing Address - Phone:706-761-1916
Mailing Address - Fax:
Practice Address - Street 1:2357 WARM SPRINGS RD STE 127
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5668
Practice Address - Country:US
Practice Address - Phone:706-761-1916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional