Provider Demographics
NPI:1609077171
Name:SCHOTT, JACQUELINE BENOIT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:BENOIT
Last Name:SCHOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1575
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39631-1575
Mailing Address - Country:US
Mailing Address - Phone:225-788-1339
Mailing Address - Fax:866-380-0722
Practice Address - Street 1:270 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MS
Practice Address - Zip Code:38631
Practice Address - Country:US
Practice Address - Phone:225-788-1339
Practice Address - Fax:866-380-0722
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC56721041C0700X
LA43661041C0700X
GACSW0028071041C0700X
TN48731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical