Provider Demographics
NPI:1548557028
Name:SCOTT, ANDREA LYN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LYN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 DECANTER DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-2686
Mailing Address - Country:US
Mailing Address - Phone:830-500-0082
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-4805
Practice Address - Fax:210-539-2126
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6517164W00000X
WALP00037094164W00000X
AK11021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No164W00000XNursing Service ProvidersLicensed Practical Nurse