Provider Demographics
NPI:1659517456
Name:SCOTT, SUZANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SCOTT
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 1:1711 CENTEX EXPRESSWAY
Mailing Address - Street 2:STE. 103
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76514
Mailing Address - Country:US
Mailing Address - Phone:254-526-7272
Mailing Address - Fax:
Practice Address - Street 1:1711 CENTEX EXPRESSWAY
Practice Address - Street 2:STE. 103
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76514
Practice Address - Country:US
Practice Address - Phone:254-526-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX412531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical