MEDICARE: MS. CYNTHIA MARIE 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	2084P0800X	Psychiatry Physician	API45233	TX
2	101YP2500X	Professional Counselor	63503	TX

General Provider Information

NPI Number	:	1548512817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA MARIE SCOTT LPC

Provider Business Mailing Address
First Line	:	156 MALONE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-8115
Country	:	US
Telephone Number	:	713-702-2670
Fax Number	:	832-834-5181

Provider Business Practice Location Address
First Line	:	156 MALONE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-8115
Country	:	US
Telephone Number	:	713-702-2670
Fax Number	:	832-834-5181

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

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	12/31/2020

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