Provider Demographics
NPI:1558370288
Name:SCOTT, LYNNE D (ED,D,,LMFT)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:D
Last Name:SCOTT
Suffix:
Gender:F
Credentials:ED,D,,LMFT
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 519
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-0519
Mailing Address - Country:US
Mailing Address - Phone:770-961-6281
Mailing Address - Fax:770-961-1434
Practice Address - Street 1:6188 HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1028
Practice Address - Country:US
Practice Address - Phone:770-961-6281
Practice Address - Fax:770-961-1434
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT000731106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist