Provider Demographics
NPI:1093323214
Name:MORAN, SCOTT (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MORAN
Suffix:
Gender:M
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42114 BILLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-7302
Mailing Address - Country:US
Mailing Address - Phone:985-640-6884
Mailing Address - Fax:
Practice Address - Street 1:902 C M FAGAN DR STE F
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6043
Practice Address - Country:US
Practice Address - Phone:985-218-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty