Lee Ann Scott, PH.D.

Key facts

NPI

1154498004

Entity type

Individual (NPI type 1)

Primary specialty

Psychologist 103T00000X

License

PSY002411 (GA)

Practice address

110 Rushing Lane
PO Box 1681
Statesboro, GA 30459

Phone

(912) 225-6447

Fax

(800) 470-4397

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

Yes

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.

• East Georgia Counseling Services, Inc. Clinical Social Worker · Statesboro, GA · NPI 1518279793
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Philosophy

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154498004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 WESTOVER DRIVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-682-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 RUSHING LANE",
            "address_2": "PO BOX 1681",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30459",
            "telephone_number": "912-225-6447",
            "fax_number": "800-470-4397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 E Ogeechee St",
            "address_purpose": "LOCATION",
            "city": "Sylvania",
            "state": "GA",
            "postal_code": "304672401",
            "country_code": "US",
            "telephone_number": "912-564-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "LEE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP MEDICAID",
            "identifier": "10046939",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00859042A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Statesboro, GA · Psychologist in Georgia