Provider Demographics
NPI:1598799074
Name:SCOTT, LEROY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:LEROY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 249
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1904
Mailing Address - Country:US
Mailing Address - Phone:407-622-6121
Mailing Address - Fax:407-622-1185
Practice Address - Street 1:323 EAST KENNEDY BLVD.
Practice Address - Street 2:SUITE G
Practice Address - City:EATONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-622-6121
Practice Address - Fax:407-622-1185
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health