Provider Demographics
NPI:1962830604
Name:SCOTT, KRISTA (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:SCOTT PLIONIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1473 28TH ST S APT 5
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3729
Mailing Address - Country:US
Mailing Address - Phone:505-795-0654
Mailing Address - Fax:
Practice Address - Street 1:1473 28TH ST S APT 5
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3729
Practice Address - Country:US
Practice Address - Phone:505-795-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500791181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical