Provider Demographics
NPI:1194013318
Name:SCOTT, JEANETTE ANN (MA, LMHCA)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:ANN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-7517
Mailing Address - Country:US
Mailing Address - Phone:253-439-8553
Mailing Address - Fax:
Practice Address - Street 1:2625 N 21ST ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-7517
Practice Address - Country:US
Practice Address - Phone:253-439-8553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60161565101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health