Provider Demographics
NPI:1578342713
Name:SCOTT, CRYSTAL M (MSW)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7827 BLUEFIN TRL
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-3463
Mailing Address - Country:US
Mailing Address - Phone:678-949-8669
Mailing Address - Fax:
Practice Address - Street 1:7827 BLUEFIN TRL
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-3463
Practice Address - Country:US
Practice Address - Phone:678-949-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker