Provider Demographics
NPI:1932188091
Name:SCOTT, VICKI ELLEN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:ELLEN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:ELLEN
Other - Last Name:WOMACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21289 N 66TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6413
Mailing Address - Country:US
Mailing Address - Phone:602-527-1319
Mailing Address - Fax:855-894-0967
Practice Address - Street 1:21448 N 75TH AVE.
Practice Address - Street 2:#6
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5978
Practice Address - Country:US
Practice Address - Phone:623-572-8053
Practice Address - Fax:855-894-0967
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC2452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional