Provider Demographics
NPI:1740310127
Name:SCOTT, JOANN LYNN (LCSW, RAS, BCD, CAS)
Entity type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW, RAS, BCD, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BROADWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-7417
Mailing Address - Country:US
Mailing Address - Phone:619-401-5500
Mailing Address - Fax:619-401-5454
Practice Address - Street 1:1000 BROADWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-7417
Practice Address - Country:US
Practice Address - Phone:619-401-5500
Practice Address - Fax:619-401-5454
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 182481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWSW18248AMedicare PIN