Provider Demographics
NPI:1104454016
Name:SCOTT, KARMEN KAY (PLPC)
Entity type:Individual
Prefix:
First Name:KARMEN
Middle Name:KAY
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20396 CR 240
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:MO
Mailing Address - Zip Code:64633-8151
Mailing Address - Country:US
Mailing Address - Phone:660-247-5534
Mailing Address - Fax:
Practice Address - Street 1:20396 CR 240
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MO
Practice Address - Zip Code:64633-8151
Practice Address - Country:US
Practice Address - Phone:660-247-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020001220101Y00000X, 101YP2500X
MO507085101YS0200X
MO2010001220101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2020001220OtherMISSOURI DEPARTMENT OF DIVISION OF PROFESSIONAL REGISTRATION