Provider Demographics
NPI:1922054683
Name:PERSINGER, SCOTT E (LCSW)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:PERSINGER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6835 BROOKFIELD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-3006
Mailing Address - Country:US
Mailing Address - Phone:210-430-5390
Mailing Address - Fax:210-265-3001
Practice Address - Street 1:2424 BABCOCK RD
Practice Address - Street 2:STE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6031
Practice Address - Country:US
Practice Address - Phone:210-430-5390
Practice Address - Fax:210-265-3001
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical