Provider Demographics
NPI:1851887178
Name:SCOTT, IVY (LCSW-C)
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10440 LITTLE PATUXENT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3648
Mailing Address - Country:US
Mailing Address - Phone:302-409-1585
Mailing Address - Fax:
Practice Address - Street 1:10440 LITTLE PATUXENT PKWY STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3648
Practice Address - Country:US
Practice Address - Phone:302-409-1585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22214104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ$$$$$$$$$OtherSOCIAL SECURITY
NJ$$$$$$$$$OtherSOCIAL SECURITY