Provider Demographics
NPI:1508375320
Name:BRUCE-SCOTT, AUTUMN Y (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:Y
Last Name:BRUCE-SCOTT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 DOUGLAS BLVD # 85-427
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3811
Mailing Address - Country:US
Mailing Address - Phone:916-365-2046
Mailing Address - Fax:
Practice Address - Street 1:4320 AUBURN BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4153
Practice Address - Country:US
Practice Address - Phone:916-418-0828
Practice Address - Fax:916-418-0838
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12630101YP2500X
CA92712106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional