Provider Demographics
NPI:1922595750
Name:SCOTT, KALI C (LPCC)
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5386 COX SMITH RD # A
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6803
Mailing Address - Country:US
Mailing Address - Phone:513-972-5120
Mailing Address - Fax:
Practice Address - Street 1:5386 COX SMITH RD # A
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6803
Practice Address - Country:US
Practice Address - Phone:513-972-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.162204101YA0400X
OHE.2404860101YM0800X
OHC.2002440-TRNE101YM0800X
OHC.2103909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0287198Medicaid