Provider Demographics
NPI:1447497672
Name:DOLL, JOHN SCOTT (LPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SCOTT
Last Name:DOLL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1506 BEXAR CROSSING ST
Mailing Address - Street 2:ATTN: JACKIE GRAYSON
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1587
Mailing Address - Country:US
Mailing Address - Phone:210-832-5000
Mailing Address - Fax:210-832-5005
Practice Address - Street 1:7404 HWY 90 W
Practice Address - Street 2:BUILDING#7
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-4024
Practice Address - Country:US
Practice Address - Phone:210-832-5000
Practice Address - Fax:210-832-5005
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX58016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197867801Medicaid