Provider Demographics
NPI:1578937520
Name:SCOTT, LAKESHIA RENAY (LPC)
Entity Type:Individual
Prefix:
First Name:LAKESHIA
Middle Name:RENAY
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 WILLIS RD APT 14
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-4721
Mailing Address - Country:US
Mailing Address - Phone:706-580-7262
Mailing Address - Fax:706-243-4243
Practice Address - Street 1:220 DOZIER ROAD
Practice Address - Street 2:
Practice Address - City:TALBOTTON
Practice Address - State:GA
Practice Address - Zip Code:31827-3182
Practice Address - Country:US
Practice Address - Phone:706-580-7262
Practice Address - Fax:706-243-4243
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008611101YP2500X
AL3528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional