Provider Demographics
NPI:1770608077
Name:SCOTT, STEPHANIE K (PHD, LMHC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:K
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 952171
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-2171
Mailing Address - Country:US
Mailing Address - Phone:407-324-7579
Mailing Address - Fax:407-324-7088
Practice Address - Street 1:101 TIMBERLACHEN CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6124
Practice Address - Country:US
Practice Address - Phone:407-324-7579
Practice Address - Fax:407-324-7088
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7490101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ101DOtherBCBS ID#