Provider Demographics
NPI:1619047719
Name:SCOTT, ROBERT E (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:SCOTT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WESLAYAN ST STE 271
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5763
Mailing Address - Country:US
Mailing Address - Phone:281-686-6294
Mailing Address - Fax:
Practice Address - Street 1:3000 WESLAYAN ST STE 271
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5763
Practice Address - Country:US
Practice Address - Phone:281-686-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0640492-01Medicaid
TX0640492-01Medicaid