Provider Demographics
NPI:1417199977
Name:SCOTT, NITA SMITH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NITA
Middle Name:SMITH
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 1:3296 SULLIVAN RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348-8574
Mailing Address - Country:US
Mailing Address - Phone:850-584-2531
Mailing Address - Fax:
Practice Address - Street 1:3296 SULLIVAN RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-8574
Practice Address - Country:US
Practice Address - Phone:850-584-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1838106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist