Provider Demographics
NPI:1902999790
Name:SCOTT, ANDREA SMITH (LPC/ LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:SMITH
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC/ LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 SAWGRASS CT
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-1777
Mailing Address - Country:US
Mailing Address - Phone:540-776-0175
Mailing Address - Fax:540-776-0488
Practice Address - Street 1:4045 POSTAL DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6439
Practice Address - Country:US
Practice Address - Phone:540-776-0175
Practice Address - Fax:540-776-0488
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health