Provider Demographics
NPI:1992721245
Name:SCOTT, LEARITA G (PHD)
Entity type:Individual
Prefix:DR
First Name:LEARITA
Middle Name:G
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 MASSACHUSETTS AVE NW
Mailing Address - Street 2:APT. #LT-08
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4757
Mailing Address - Country:US
Mailing Address - Phone:202-966-2979
Mailing Address - Fax:202-966-2975
Practice Address - Street 1:4100 MASSACHUSETTS AVE NW
Practice Address - Street 2:APT. #LT-08
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4757
Practice Address - Country:US
Practice Address - Phone:202-966-2979
Practice Address - Fax:202-966-2975
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004966L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health