Provider Demographics
NPI:1760977870
Name:SCOTT-BOISSARD, DIONNE RENE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DIONNE
Middle Name:RENE
Last Name:SCOTT-BOISSARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 S MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-1641
Mailing Address - Country:US
Mailing Address - Phone:845-778-8679
Mailing Address - Fax:
Practice Address - Street 1:154 S MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1641
Practice Address - Country:US
Practice Address - Phone:845-778-8679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-30
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008525101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health