Provider Demographics
NPI:1841834884
Name:SCOTT, EBONI PATRICE (LPC)
Entity type:Individual
Prefix:MS
First Name:EBONI
Middle Name:PATRICE
Last Name:SCOTT
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 1:16419 QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-5715
Mailing Address - Country:US
Mailing Address - Phone:281-748-3989
Mailing Address - Fax:
Practice Address - Street 1:16419 QUAIL RUN DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5715
Practice Address - Country:US
Practice Address - Phone:281-748-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75689101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional