MEDICARE: MRS. STEPHANIE DIANE SCOTT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	8544	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518263680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE DIANE SCOTT LPC

Provider Business Mailing Address
First Line	:	PO BOX 408
Second Line	:
City	:	GRANTSBORO
State	:	NC
Zip	:	28529-0408
Country	:	US
Telephone Number	:	252-665-4618
Fax Number	:

Provider Business Practice Location Address
First Line	:	3282 WELLONS BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5234
Country	:	US
Telephone Number	:	252-745-7401
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	01/17/2022

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