Provider Demographics
NPI:1447379268
Name:SCOTT, PATRICIA K (MSW LCPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:K
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW LCPC
Other - Prefix:
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Mailing Address - Street 1:7625 N EAST LAKE TERRACE
Mailing Address - Street 2:#102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626
Mailing Address - Country:US
Mailing Address - Phone:773-412-1459
Mailing Address - Fax:773-761-2998
Practice Address - Street 1:148 S BLOOMINGDALE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:630-894-4451
Practice Address - Fax:630-894-2876
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02221520OtherBCBS