Healthcare Provider Details

I. General information

NPI: 1346287885
Provider Name (Legal Business Name): CAROL ABBOTT SCOTT CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 VIOLET RD
CRITTENDEN KY
41030-7480
US

IV. Provider business mailing address

502 FARRELL DR
COVINGTON KY
41011-3717
US

V. Phone/Fax

Practice location:
  • Phone: 859-428-4100
  • Fax: 859-428-2134
Mailing address:
  • Phone: 859-331-3292
  • Fax: 859-578-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4673
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: