MEDICARE: MOUNT SCOTT COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5275	OK

General Provider Information

NPI Number	:	1629494661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT SCOTT COUNSELING PLLC

Provider Business Mailing Address
First Line	:	PO BOX 413
Second Line	:
City	:	MEDICINE PARK
State	:	OK
Zip	:	73557-0413
Country	:	US
Telephone Number	:	580-331-8065
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 EAST LAKE DR.
Second Line	:
City	:	MEDICINE PARK
State	:	OK
Zip	:	73557-0413
Country	:	US
Telephone Number	:	580-331-8065
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MR. NOLAN ARRAN LAWLESS
Credential	:	MS, LPC
Telephone Number	:	580-331-8065

Provider Enumeration Date	:	03/14/2014
Last Update Date	:	03/14/2014

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