Provider Demographics
NPI:1780808899
Name:BROWNLEY, SCOTTI L (LPC)
Entity type:Individual
Prefix:MS
First Name:SCOTTI
Middle Name:L
Last Name:BROWNLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 JACOB ST
Mailing Address - Street 2:
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2012
Mailing Address - Country:US
Mailing Address - Phone:208-238-0855
Mailing Address - Fax:
Practice Address - Street 1:MISSION ROAD BLDG 248
Practice Address - Street 2:FORT HALL INDIAN AGENCY
Practice Address - City:FORT HALL
Practice Address - State:ID
Practice Address - Zip Code:83203
Practice Address - Country:US
Practice Address - Phone:208-237-5631
Practice Address - Fax:208-237-5796
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3729101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional