Provider Demographics
NPI:1265086508
Name:SCOTT, ALISSA MARIE (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:MARIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-7811
Mailing Address - Country:US
Mailing Address - Phone:910-995-3497
Mailing Address - Fax:
Practice Address - Street 1:135 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7811
Practice Address - Country:US
Practice Address - Phone:910-995-3497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0139051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical