Provider Demographics
NPI:1275665465
Name:SCOTT, BEVERLY A (LMFT)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3143 CLAYTON ROAD
Mailing Address - Street 2:STE B
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519
Mailing Address - Country:US
Mailing Address - Phone:925-680-1717
Mailing Address - Fax:925-680-1711
Practice Address - Street 1:3143 CLAYTON ROAD
Practice Address - Street 2:STE B
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519
Practice Address - Country:US
Practice Address - Phone:925-680-1717
Practice Address - Fax:925-680-1711
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15622106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist