Provider Demographics
NPI:1740321728
Name:SCOTT, MARY LADELL (MSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:LADELL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 SHORELINE DR APT 6502
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-4577
Mailing Address - Country:US
Mailing Address - Phone:813-748-5393
Mailing Address - Fax:
Practice Address - Street 1:6551 SHORELINE DR APT 6502
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33708-4577
Practice Address - Country:US
Practice Address - Phone:813-748-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical