Provider Demographics
NPI:1710452867
Name:SCOTT, DEIRDRE JILL (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:DEIRDRE
Middle Name:JILL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 MONTCLAIR RD STE A
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2645
Mailing Address - Country:US
Mailing Address - Phone:205-618-9899
Mailing Address - Fax:205-618-9899
Practice Address - Street 1:1830 MONTCLAIR RD STE A
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-2645
Practice Address - Country:US
Practice Address - Phone:205-618-9899
Practice Address - Fax:205-618-9899
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3747101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)