Provider Demographics
NPI:1275680365
Name:SCOTT, SARA (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:DICKENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:704 CROWN CT
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-2334
Mailing Address - Country:US
Mailing Address - Phone:615-758-4158
Mailing Address - Fax:615-758-4128
Practice Address - Street 1:4207 LEBANON PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1200
Practice Address - Country:US
Practice Address - Phone:615-758-4158
Practice Address - Fax:615-541-4910
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001785101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional