Provider Demographics
NPI:1427182203
Name:SCOTT, ROY H (LPCC)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:H
Last Name:SCOTT
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11A LEAPING POWDER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-5923
Mailing Address - Country:US
Mailing Address - Phone:505-581-4728
Mailing Address - Fax:505-581-0030
Practice Address - Street 1:STATE ROAD 571
Practice Address - Street 2:#28
Practice Address - City:EL RITO
Practice Address - State:NM
Practice Address - Zip Code:87530-0237
Practice Address - Country:US
Practice Address - Phone:505-571-4728
Practice Address - Fax:505-581-0030
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0093301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health