Healthcare Provider Details

I. General information

NPI: 1679754519
Provider Name (Legal Business Name): SCOTT BENJAMIN BELANGER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W GIACONDA WAY STE 135
TUCSON AZ
85704-4350
US

IV. Provider business mailing address

205 W GIACONDA WAY STE 135
TUCSON AZ
85704-4350
US

V. Phone/Fax

Practice location:
  • Phone: 520-954-9930
  • Fax:
Mailing address:
  • Phone: 520-954-9930
  • Fax: 520-342-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3934
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3934
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: