Provider Demographics
NPI:1013785468
Name:SCOTT, LISA M (AMFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 GREEN VALLEY CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7012
Mailing Address - Country:US
Mailing Address - Phone:310-709-4713
Mailing Address - Fax:
Practice Address - Street 1:5601 W SLAUSON AVE STE 192
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6569
Practice Address - Country:US
Practice Address - Phone:424-331-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist