Provider Demographics
NPI:1821182510
Name:SCOTT, JULIE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 S 66TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3928
Mailing Address - Country:US
Mailing Address - Phone:479-799-1859
Mailing Address - Fax:
Practice Address - Street 1:2315 S 66TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3928
Practice Address - Country:US
Practice Address - Phone:479-799-1859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1843-M104100000X
MELC216211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker