Provider Demographics
NPI:1770983595
Name:SCOTT, E. HITCHCOCK (LPCC917, LAADC)
Entity type:Individual
Prefix:DR
First Name:E.
Middle Name:HITCHCOCK
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPCC917, LAADC
Other - Prefix:DR
Other - First Name:ERICHA
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AS ABOVE & ATR-BC
Mailing Address - Street 1:PO BOX 6806
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90264-6806
Mailing Address - Country:US
Mailing Address - Phone:310-880-9761
Mailing Address - Fax:
Practice Address - Street 1:28990 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-3952
Practice Address - Country:US
Practice Address - Phone:310-880-9761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALR1080411101YA0400X
CALPCC917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)