Provider Demographics
NPI:1598339988
Name:SCOTT, CENA M (BSW, MS, ADC-IP)
Entity Type:Individual
Prefix:MS
First Name:CENA
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:BSW, MS, ADC-IP
Other - Prefix:MS
Other - First Name:CENA
Other - Middle Name:M
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSW, MS, ADC-IP
Mailing Address - Street 1:93 THE TWINS RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-5254
Mailing Address - Country:US
Mailing Address - Phone:843-230-0532
Mailing Address - Fax:
Practice Address - Street 1:115 SHORT ST
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3924
Practice Address - Country:US
Practice Address - Phone:843-355-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty