Provider Demographics
NPI:1871845230
Name:BURCH-SCOTT, FRANCES (D MIN,BCCC)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:
Last Name:BURCH-SCOTT
Suffix:
Gender:F
Credentials:D MIN,BCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 CRIPPLE CREEK DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2109
Mailing Address - Country:US
Mailing Address - Phone:678-663-1827
Mailing Address - Fax:
Practice Address - Street 1:4013 CRIPPLE CREEK DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2109
Practice Address - Country:US
Practice Address - Phone:678-663-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA07125170101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor