Provider Demographics
NPI:1467577353
Name:SCALES, KATHRYN COOK (MED, LPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:COOK
Last Name:SCALES
Suffix:
Gender:F
Credentials:MED, LPC
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 8098
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-0001
Mailing Address - Country:US
Mailing Address - Phone:864-316-9711
Mailing Address - Fax:864-474-3695
Practice Address - Street 1:323 W SOUTH STREET
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379
Practice Address - Country:US
Practice Address - Phone:864-316-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4589Medicaid
SCGP4590Medicaid
SC1043355431OtherGROUP NPI #
SCGP4614Medicaid
SC1992840375OtherGROUP NPI #
SC1164567558OtherGROUP NPI #