Provider Demographics
NPI:1558114629
Name:SCOTT, MICHEL ORION (LPC-A)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:ORION
Last Name:SCOTT
Suffix:
Gender:M
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 ROUNDUP TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1632
Mailing Address - Country:US
Mailing Address - Phone:512-825-3484
Mailing Address - Fax:
Practice Address - Street 1:4817 ROUNDUP TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1632
Practice Address - Country:US
Practice Address - Phone:512-825-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health