Provider Demographics
NPI:1417598038
Name:SCOTT, RENATE (LPC)
Entity Type:Individual
Prefix:
First Name:RENATE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13885 HEDGEWOOD DR STE 245
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-7931
Mailing Address - Country:US
Mailing Address - Phone:703-490-0336
Mailing Address - Fax:703-490-4525
Practice Address - Street 1:601 JEFFERSON DAVIS HWY STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4564
Practice Address - Country:US
Practice Address - Phone:703-490-0336
Practice Address - Fax:703-490-4525
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional