Provider Demographics
NPI:1225751696
Name:SCOTT, SARAH ARLEEN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ARLEEN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 ADELINE ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-3875
Mailing Address - Country:US
Mailing Address - Phone:601-352-3932
Mailing Address - Fax:
Practice Address - Street 1:610 ADELINE ST STE 1A
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-3875
Practice Address - Country:US
Practice Address - Phone:601-325-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
MS101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional