Provider Demographics
NPI:1659935831
Name:SCOTT, ASHLEY PAGE (MS, LPC, RPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PAGE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14673 MIDWAY RD STE 107
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3542
Mailing Address - Country:US
Mailing Address - Phone:469-912-1609
Mailing Address - Fax:
Practice Address - Street 1:14673 MIDWAY RD STE 107
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3542
Practice Address - Country:US
Practice Address - Phone:469-912-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67855101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty