Healthcare Provider Details

I. General information

NPI: 1881556330
Provider Name (Legal Business Name): LISA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 VANDERFORD ST
SALISBURY NC
28144-4027
US

IV. Provider business mailing address

211 VANDERFORD ST
SALISBURY NC
28144-4027
US

V. Phone/Fax

Practice location:
  • Phone: 704-754-0924
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberP021646
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: