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General NPI Number Information
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NPI Number | 1346230778
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Entity Type | Individual
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Provider Name | TRESA ANNE SCOTT LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2740 PROSPERITY AVE 300
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City | FAIRFAX
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State | VA
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Zip | 22031-4307
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Country | US
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Telephone | 703-970-4180
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Fax | 703-275-5826
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Provider Business Mailing Address
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Address Line | 7311 LIGHTSHIP CT
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City | BURKE
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State | VA
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Zip | 22015-4419
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Country | US
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Telephone | 703-569-7940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 07912
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License Number State | MD
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