MEDICARE: PHYLICIA 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	106S00000X	Behavior Technician
2	101YP2500X	Professional Counselor	8399	LA

General Provider Information

NPI Number	:	1609305549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLICIA SCOTT LPC

Provider Business Mailing Address
First Line	:	PO BOX 66558
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70896-6558
Country	:	US
Telephone Number	:	225-925-4282
Fax Number	:	225-362-5319

Provider Business Practice Location Address
First Line	:	2455 WOODDALE BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70805-7569
Country	:	US
Telephone Number	:	225-922-3169
Fax Number	:	225-922-3225

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

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	06/09/2026

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