Provider Demographics
NPI:1285306472
Name:SCOTT, KATHY LYNN (LCDC)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:LYNN
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 N SAM HOUSTON PKWY E STE 308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4086
Mailing Address - Country:US
Mailing Address - Phone:281-999-4859
Mailing Address - Fax:
Practice Address - Street 1:505 N SAM HOUSTON PKWY E STE 308
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4086
Practice Address - Country:US
Practice Address - Phone:281-999-4859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10820101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)