Provider Demographics
NPI:1902075609
Name:SCOTT, MIESHA DAMALA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MIESHA
Middle Name:DAMALA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 HANOVER PARKWAY SUITE C
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:301-441-2525
Mailing Address - Fax:301-441-2511
Practice Address - Street 1:7303 HANOVER PARKWAY, SUITE C
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-441-2525
Practice Address - Fax:301-441-2511
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500784751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical