Provider Demographics
NPI:1225126139
Name:SCOTT, JODIE W (LMHC)
Entity Type:Individual
Prefix:DR
First Name:JODIE
Middle Name:W
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:DR
Other - First Name:JODIE
Other - Middle Name:W
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LMHC, NCC
Mailing Address - Street 1:2802 ALOMA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3532
Mailing Address - Country:US
Mailing Address - Phone:407-628-3301
Mailing Address - Fax:407-681-2888
Practice Address - Street 1:2802 ALOMA AVE STE 101
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3532
Practice Address - Country:US
Practice Address - Phone:407-628-3301
Practice Address - Fax:407-681-2888
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH 6195OtherLIENSED MENTAL HEALTH COUNSELOR
FL012147700Medicaid
FL53009OtherNATIONALLY CERTIFIED COUNSELOR