Healthcare Provider Details

I. General information

NPI: 1396388088
Provider Name (Legal Business Name): LEVETTE SUBRAINA SCOTT PHD LPC-A NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEVETTE DAMES PHD LPC-A NCC

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 FAYETTEVILLE RD STE 211
DURHAM NC
27713-6289
US

IV. Provider business mailing address

8601 SIX FORKS RD STE 201
RALEIGH NC
27615-5931
US

V. Phone/Fax

Practice location:
  • Phone: 919-294-8981
  • Fax: 252-433-0065
Mailing address:
  • Phone: 919-294-8981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1165636
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA15071
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1187002
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15071
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: