Provider Demographics
NPI:1467026500
Name:SCOTT, LARALEA (LMSW)
Entity Type:Individual
Prefix:
First Name:LARALEA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:EFFIE
Mailing Address - State:LA
Mailing Address - Zip Code:71331-0127
Mailing Address - Country:US
Mailing Address - Phone:318-206-7795
Mailing Address - Fax:
Practice Address - Street 1:5411 COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3729
Practice Address - Country:US
Practice Address - Phone:318-484-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA153311041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical