Provider Demographics
NPI:1477094431
Name:ESSE, SCOTT (LPC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:ESSE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 FORD STREET
Mailing Address - Street 2:
Mailing Address - City:LLANO
Mailing Address - State:TX
Mailing Address - Zip Code:78643-1203
Mailing Address - Country:US
Mailing Address - Phone:325-247-4477
Mailing Address - Fax:
Practice Address - Street 1:1203 FORD STREET
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-1203
Practice Address - Country:US
Practice Address - Phone:325-247-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71144106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician