Provider Demographics
NPI:1992969372
Name:SCOTT, PAULETTE DENESE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:PAULETTE
Middle Name:DENESE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:PAULETTE
Other - Middle Name:DENESE
Other - Last Name:DOTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:8821 HERON'S FLIGHT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723
Mailing Address - Country:US
Mailing Address - Phone:301-442-6073
Mailing Address - Fax:202-584-1249
Practice Address - Street 1:8821 HERON'S FLIGHT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723
Practice Address - Country:US
Practice Address - Phone:301-442-6073
Practice Address - Fax:202-584-1249
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3011631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical