Healthcare Provider Details

I. General information

NPI: 1043146517
Provider Name (Legal Business Name): SCOTT LIPPITT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 BARCLAY CIR STE 400
ROCHESTER HILLS MI
48307-5812
US

IV. Provider business mailing address

4905 CROOKS RD
ROYAL OAK MI
48073-1259
US

V. Phone/Fax

Practice location:
  • Phone: 248-957-6444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: