Provider Demographics
NPI:1912550070
Name:SCOTT, CHAROLETTE S (LPC)
Entity Type:Individual
Prefix:
First Name:CHAROLETTE
Middle Name:S
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHAROLETTE
Other - Middle Name:S
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 352
Mailing Address - Street 2:
Mailing Address - City:GUY
Mailing Address - State:AR
Mailing Address - Zip Code:72061-0352
Mailing Address - Country:US
Mailing Address - Phone:870-899-0884
Mailing Address - Fax:870-587-1514
Practice Address - Street 1:1813 EXECUTIVE SQ
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6086
Practice Address - Country:US
Practice Address - Phone:870-899-0884
Practice Address - Fax:870-587-1514
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1907083101YM0800X
ARP2207002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health