Provider Demographics
NPI:1982761128
Name:PETIT, SCOTT (LMHC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PETIT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 5TH AVE NE APT 103
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4171
Mailing Address - Country:US
Mailing Address - Phone:206-522-8700
Mailing Address - Fax:
Practice Address - Street 1:8401 5TH AVE NE APT 103
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4171
Practice Address - Country:US
Practice Address - Phone:206-522-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health