Provider Demographics
NPI:1134404767
Name:SCOTT, LEAH V (MS,LPC)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:V
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2016
Mailing Address - Country:US
Mailing Address - Phone:267-872-5546
Mailing Address - Fax:
Practice Address - Street 1:1236 S 57TH ST APT 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3938
Practice Address - Country:US
Practice Address - Phone:267-872-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health