Individual provider Active NPI

Leesa Celeste Scott-Morrow, PH.D.

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1093735045
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4836 Issued in MN
Practice address
5331 Emerson Ave S
Minneapolis, MN 55419-1112
Phone
(612) 618-9670
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4836 MN Primary
Clinical Psychologist 103TC0700X 33052 TX

Addresses

Primary practice location

5331 Emerson Ave S
Minneapolis, MN 55419-1112

Mailing address

5331 Emerson Ave S
Minneapolis, MN 55419-1112
Phone (612) 618-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33052TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shadeland Anesthesia & Pain Associates Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1093735045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 EMERSON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191112",
            "telephone_number": "612-618-9670",
            "fax_number": "612-371-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 EMERSON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191112",
            "telephone_number": "612-618-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT-MORROW",
        "first_name": "LEESA",
        "middle_name": "CELESTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4836",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.