Provider Demographics
NPI:1306236096
Name:SCOTES, ATHENA PENELOPE (LMHC)
Entity type:Individual
Prefix:MS
First Name:ATHENA
Middle Name:PENELOPE
Last Name:SCOTES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 NW FRESCO WAY APT 205
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-3546
Mailing Address - Country:US
Mailing Address - Phone:772-631-7402
Mailing Address - Fax:
Practice Address - Street 1:430 SW CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2918
Practice Address - Country:US
Practice Address - Phone:772-631-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health