Healthcare Provider Details

I. General information

NPI: 1427577535
Provider Name (Legal Business Name): ANISHA RENAE SCOTT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 PEACHTREE RD NE STE 2200
ATLANTA GA
30326-1156
US

IV. Provider business mailing address

2515 RIDGEWOOD WAY
PHENIX CITY AL
36870-2391
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-7088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW010417
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7041C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: