Healthcare Provider Details

I. General information

NPI: 1588376446
Provider Name (Legal Business Name): LISA SCOTT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5604 COLISEUM BLVD STE B
ALEXANDRIA LA
71303-3993
US

IV. Provider business mailing address

5604 COLISEUM BLVD STE B
ALEXANDRIA LA
71303-3993
US

V. Phone/Fax

Practice location:
  • Phone: 318-487-5282
  • Fax: 318-487-5481
Mailing address:
  • Phone: 318-487-5282
  • Fax: 318-487-5481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9581
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: