Charlesetta Shelton Scott, M.D.

Individual provider Active NPI Child & Adolescent Psychiatry Physician · Atlanta, GA

NPI 1285752196 · NPPES record last updated Aug 2, 2012

Key facts

NPI
1285752196
Entity type
Individual (NPI type 1)
Primary specialty
Child & Adolescent Psychiatry Physician 2084P0804X
License
032472 (GA)
Practice address
317 Woodward Ave SE
Atlanta, GA 30312-2123
Phone
(404) 432-1531
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

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 Medicine

State licenses

LicenseStateTypeSpecialty
032472GAMDChild & Adolescent Psychiatry Physician
036.120082ILMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Counseling Service, Inc Current
since Sep 11, 2012
Accepting new patients
West Cobb Medical Associates, LLC Past
since Oct 1, 2017
Accepting new patients

Locations

1299 Battlecreek Rd
Ste 100
Jonesboro, GA 30236
Phone (770) 471-0033

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5606/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 036.120082 IL
Child & Adolescent Psychiatry Physician 2084P0804X 032472 GA Yes

Addresses

Primary practice location

317 Woodward Ave SE
Atlanta, GA 30312-2123

Mailing address

317 Woodward Ave SE
Atlanta, GA 30312-2123
Phone (404) 432-1531

Other names

  • Dr. Charlesetta Shelton-Scott Former name

Other providers in Atlanta, GA

All providers in Atlanta, GA · Child & Adolescent Psychiatry Physician in Georgia

Sources for this page

Verify at the official NPI Registry.