Provider Demographics
NPI:1598966582
Name:SCOTT, CHRISTENE RAENEA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTENE
Middle Name:RAENEA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CHRISTENE
Other - Middle Name:RAENEA
Other - Last Name:SMART-LEADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4500 S GARNETT RD STE 908
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5214
Mailing Address - Country:US
Mailing Address - Phone:918-808-8309
Mailing Address - Fax:918-602-1207
Practice Address - Street 1:4500 S GARNETT RD STE 908
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5214
Practice Address - Country:US
Practice Address - Phone:918-829-4374
Practice Address - Fax:918-602-1207
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101Y00000X
101YA0400X
OK5204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1861877441OtherORGANIZATIONAL NPI