Provider Demographics
NPI:1124249974
Name:LEGRAND, SCOTT PETER (LCSW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:PETER
Last Name:LEGRAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 RIVECON AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-467-0181
Mailing Address - Fax:407-977-0252
Practice Address - Street 1:2180 SNOWHILL ROAD
Practice Address - Street 2:
Practice Address - City:CHULUOTA
Practice Address - State:FL
Practice Address - Zip Code:32766
Practice Address - Country:US
Practice Address - Phone:407-977-0336
Practice Address - Fax:407-977-0252
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 66631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical