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NPI Code Detail

MEDICARE: SHANNON STEPHANIE SCOTT LPCA

MEDICARE: SHANNON STEPHANIE SCOTT LPCA
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
1101YP2500XProfessional Counselor8057SC
2101YA0400XAddiction (Substance Use Disorder) Counselor8057SC

General Provider Information

NPI Number : 1962111708
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON STEPHANIE SCOTT LPCA
Provider Business Mailing Address
First Line : 9699 SEED ST
Second Line :
City : LADSON
State : SC
Zip : 29456-6746
Country : US
Telephone Number : 843-557-4303
Fax Number :
Provider Business Practice Location Address
First Line : 320 MIDLAND PKWY STE C
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29485-7195
Country : US
Telephone Number : 843-871-4790
Fax Number : 844-965-9336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2022
Last Update Date : 11/21/2022

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Directions to “ SHANNON STEPHANIE SCOTT LPCA” Practice Location

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