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General NPI Number Information
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NPI Number | 1669516266
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Entity Type | Individual
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Provider Name | ROBERT L SCOTT LMFT
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5600 GOODMAN ROAD SUITE B
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City | OLIVE BRANCH
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State | MS
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Zip | 38654
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Country | US
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Telephone | 662-893-6556
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Fax | 662-893-1102
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Provider Business Mailing Address
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Address Line | 5600 GOODMAN RD SUITE B
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-7002
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Country | US
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Telephone | 662-893-6556
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Fax | 662-893-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | AD04-038S
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | TO158
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License Number State | MS
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