Provider Demographics
NPI:1962684910
Name:SCOTT-ADAMS, ROSLYNN OLIVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSLYNN
Middle Name:OLIVIA
Last Name:SCOTT-ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 MILROY LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-5774
Mailing Address - Country:US
Mailing Address - Phone:301-266-8094
Mailing Address - Fax:
Practice Address - Street 1:3007 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-2822
Practice Address - Country:US
Practice Address - Phone:713-528-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC00068791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical