Provider Demographics
NPI:1750762696
Name:SCOTT, MICHELLE K (LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:K
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 1:1911 GALLERIA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4617
Mailing Address - Country:US
Mailing Address - Phone:903-792-0308
Mailing Address - Fax:
Practice Address - Street 1:1911 GALLERIA OAKS DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4617
Practice Address - Country:US
Practice Address - Phone:210-446-8255
Practice Address - Fax:888-823-3497
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional