Healthcare Provider Details

I. General information

NPI: 1265176077
Provider Name (Legal Business Name): ALLISON SCOTT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8037 UNRUH DR
GEORGETOWN IN
47122-8759
US

IV. Provider business mailing address

8134 NEW LAGRANGE ROAD SUITE 100
LOUISVILLE KY
40222
US

V. Phone/Fax

Practice location:
  • Phone: 812-968-4899
  • Fax:
Mailing address:
  • Phone: 502-767-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number256604
License Number StateKY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7100810420
Identifier TypeMEDICAID
Identifier StateKY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: