MEDICARE: PATRICIA A SCOTT LCSW

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	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5X743	OTHER	AR	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1932196425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA A SCOTT LCSW

Provider Business Mailing Address
First Line	:	114 COUNTRY CLUB RD
Second Line	:
City	:	SHERWOOD
State	:	AR
Zip	:	72120-4625
Country	:	US
Telephone Number	:	501-834-2727
Fax Number	:	501-834-2242

Provider Business Practice Location Address
First Line	:	114 COUNTRY CLUB RD
Second Line	:
City	:	SHERWOOD
State	:	AR
Zip	:	72120-3226
Country	:	US
Telephone Number	:	501-834-2727
Fax Number	:	501-834-2242

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/16/2014

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Directions to “ PATRICIA A SCOTT LCSW” Practice Location

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