Provider Demographics
NPI:1649519521
Name:SCOTT, JESSICA BROOKE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BROOKE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 CROWN FEATHERS DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-7416
Mailing Address - Country:US
Mailing Address - Phone:405-408-7745
Mailing Address - Fax:
Practice Address - Street 1:2932 NW 122ND ST STE 10
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-1955
Practice Address - Country:US
Practice Address - Phone:405-242-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist