Provider Demographics
NPI:1639211014
Name:SCOTT, KAREN LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:SCOTT KUBRAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:3519 PELHAM RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4182
Mailing Address - Country:US
Mailing Address - Phone:864-234-6778
Mailing Address - Fax:864-234-2474
Practice Address - Street 1:3519 PELHAM RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4182
Practice Address - Country:US
Practice Address - Phone:864-234-6778
Practice Address - Fax:864-234-2474
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC743103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist