Provider Demographics
NPI:1154577062
Name:KINGSLEY-SCOTT, SHAWNA CLAIRE
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:CLAIRE
Last Name:KINGSLEY-SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 STONE HARBOR WAY
Mailing Address - Street 2:UNIT A1
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3404
Mailing Address - Country:US
Mailing Address - Phone:561-577-7044
Mailing Address - Fax:
Practice Address - Street 1:110 STONE HARBOR WAY
Practice Address - Street 2:UNIT A1
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3404
Practice Address - Country:US
Practice Address - Phone:561-577-7044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health