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: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 BROOKSTONE CENTRE PKWY
COLUMBUS GA
31904-9248
US

IV. Provider business mailing address

2515 RIDGEWOOD WAY
PHENIX CITY AL
36870-2391
US

V. Phone/Fax

Practice location:
  • Phone: 706-940-5677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: