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General NPI Number Information
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NPI Number | 1578937520
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Entity Type | Individual
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Provider Name | LAKESHIA RENAY SCOTT LPC
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Gender | Female
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 220 DOZIER ROAD
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City | TALBOTTON
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State | GA
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Zip | 31827-3182
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Country | US
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Telephone | 706-580-7262
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Fax | 706-243-4243
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Provider Business Mailing Address
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Address Line | 3714 WILLIS RD APT 14
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City | COLUMBUS
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State | GA
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Zip | 31904-4721
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Country | US
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Telephone | 706-580-7262
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Fax | 706-243-4243
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC008611
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3528
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License Number State | AL
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