1225126139 NPI number — DR. JODIE W SCOTT LMHC

Table of content: DR. JODIE W SCOTT LMHC (NPI 1225126139)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225126139 NPI number — DR. JODIE W SCOTT LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCOTT
Provider First Name:
JODIE
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCOTT
Provider Other First Name:
JODIE
Provider Other Middle Name:
W
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D., LMHC, NCC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225126139
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5358 BIRCHBEND LOOP
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVIEDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32765-6179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-628-3301
Provider Business Mailing Address Fax Number:
407-987-4584

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5358 BIRCHBEND LOOP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OVIEDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32765-6179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-628-3301
Provider Business Practice Location Address Fax Number:
407-987-4584
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH6195 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 012147700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53009 . This is a "NATIONALLY CERTIFIED COUNSELOR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: MH 6195 . This is a "LIENSED MENTAL HEALTH COUNSELOR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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