Healthcare Provider Details

I. General information

NPI: 1821182510
Provider Name (Legal Business Name): JULIE MARIE SCOTT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 S 66TH ST
FORT SMITH AR
72903-3928
US

IV. Provider business mailing address

2315 S 66TH ST
FORT SMITH AR
72903-3928
US

V. Phone/Fax

Practice location:
  • Phone: 479-799-1859
  • Fax:
Mailing address:
  • Phone: 479-799-1859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC21621
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2215-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: