Provider Demographics
NPI:1346230778
Name:SCOTT, TRESA ANNE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:TRESA
Middle Name:ANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 LIGHTSHIP CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4419
Mailing Address - Country:US
Mailing Address - Phone:703-569-7940
Mailing Address - Fax:
Practice Address - Street 1:2740 PROSPERITY AVE
Practice Address - Street 2:300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4307
Practice Address - Country:US
Practice Address - Phone:703-970-4180
Practice Address - Fax:703-275-5826
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD079121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical