Provider Demographics
NPI:1629519665
Name:SCALES, WILLIAM (LPC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:SCALES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2091 KINRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1883
Mailing Address - Country:US
Mailing Address - Phone:901-267-9643
Mailing Address - Fax:
Practice Address - Street 1:2091 KINRIDGE TRL
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-1883
Practice Address - Country:US
Practice Address - Phone:901-267-9643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional