Provider Demographics
NPI:1679796619
Name:SCOTT, NANCY LEE (EDD, NCSP, LCPC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:EDD, NCSP, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14960 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60083-9748
Mailing Address - Country:US
Mailing Address - Phone:847-421-8041
Mailing Address - Fax:847-249-0221
Practice Address - Street 1:14960 W 21ST ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:IL
Practice Address - Zip Code:60083-9748
Practice Address - Country:US
Practice Address - Phone:847-421-8041
Practice Address - Fax:847-249-0221
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool