Andrea Lyn Scott, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1102 Issued in AK

Practice address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504

Phone

(210) 916-4805

Fax

(210) 539-2126

NPI assigned

Jul 5, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peninsula Community Health Services of Alaska, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kenai, AK
  • NPI 1659825776
  NPD (past)
• Peninsula Community Health Services of Alaska, Inc.

  • Federally Qualified Health Center (FQHC)
  • Soldotna, AK
  • NPI 1700984614

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1548557028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 DECANTER DR",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781322686",
            "telephone_number": "830-500-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-4805",
            "fax_number": "210-539-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ANDREA",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "6517",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00037094",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "1102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saushec
• Ross Scallan
• Julia Catherine Schaffer, MD
• Richard Paul Schobitz, PHD
• Samantha Schweickhardt
• Dominique Scutella, DPT
• Nathaniel Shapiro
• Sheri Lee Sharp
• Erwin Terrance Shaw, D.O.
• Cortney Shewmaker

• Clinical Social Worker in Jbsa Ft Sam Houston, TX
• Providers in Jbsa Ft Sam Houston, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.