Provider Demographics
NPI:1326655929
Name:SCOTT, KELSIE RENETTA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELSIE
Middle Name:RENETTA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 PARKWOOD CIR SE UNIT 2312
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2162
Mailing Address - Country:US
Mailing Address - Phone:865-806-0040
Mailing Address - Fax:
Practice Address - Street 1:1201 W PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3449
Practice Address - Country:US
Practice Address - Phone:770-835-5669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0071601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical