Healthcare Provider Details

I. General information

NPI: 1902184682
Provider Name (Legal Business Name): DEBORAH SCOTT LCSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 07/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

683 SW ROCK CREEK DR
STEVENSON WA
98648-4419
US

IV. Provider business mailing address

PO BOX 255
STEVENSON WA
98648-0255
US

V. Phone/Fax

Practice location:
  • Phone: 503-810-8237
  • Fax:
Mailing address:
  • Phone: 503-810-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60147954
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4978
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: