Provider Demographics
NPI:1134408545
Name:HENIZE, SCOTT DAVI (LPC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVI
Last Name:HENIZE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 DUTTON DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7573
Mailing Address - Country:US
Mailing Address - Phone:512-396-7695
Mailing Address - Fax:512-396-7633
Practice Address - Street 1:1901 DUTTON DR
Practice Address - Street 2:SUITE E
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7573
Practice Address - Country:US
Practice Address - Phone:512-396-7695
Practice Address - Fax:512-396-7633
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64464101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)