Provider Demographics
NPI:1326646407
Name:SCOTT, CHERYL A (MS LMHC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3778 SUFFOLK DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3005
Mailing Address - Country:US
Mailing Address - Phone:850-510-1899
Mailing Address - Fax:
Practice Address - Street 1:3778 SUFFOLK DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3005
Practice Address - Country:US
Practice Address - Phone:850-510-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional