Provider Demographics
NPI:1699077818
Name:SCOTT, NKECHI (LMSW)
Entity type:Individual
Prefix:
First Name:NKECHI
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1854 KOULTER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7420
Mailing Address - Country:US
Mailing Address - Phone:803-708-4712
Mailing Address - Fax:803-708-4718
Practice Address - Street 1:1411 BARNWELL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3566
Practice Address - Country:US
Practice Address - Phone:803-708-4712
Practice Address - Fax:803-708-4718
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9441104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker