Healthcare Provider Details

I. General information

NPI: 1023795499
Provider Name (Legal Business Name): SIMONE DASHAE SCOTT PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12097 OLD HAMMOND HWY STE I4
BATON ROUGE LA
70816-8679
US

IV. Provider business mailing address

3103 HOLLY ST
ZACHARY LA
70791-2932
US

V. Phone/Fax

Practice location:
  • Phone: 225-246-8816
  • Fax:
Mailing address:
  • Phone: 225-454-5166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC9468
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: