Provider Demographics
NPI:1629494661
Name:MOUNT SCOTT COUNSELING PLLC
Entity Type:Organization
Organization Name:MOUNT SCOTT COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:ARRAN
Authorized Official - Last Name:LAWLESS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:580-331-8065
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:MEDICINE PARK
Mailing Address - State:OK
Mailing Address - Zip Code:73557-0413
Mailing Address - Country:US
Mailing Address - Phone:580-331-8065
Mailing Address - Fax:
Practice Address - Street 1:59 EAST LAKE DR.
Practice Address - Street 2:
Practice Address - City:MEDICINE PARK
Practice Address - State:OK
Practice Address - Zip Code:73557-0413
Practice Address - Country:US
Practice Address - Phone:580-331-8065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty