MEDICARE: CSCOMRIE PSYCHOLOGY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1144177700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CSCOMRIE PSYCHOLOGY PLLC

Provider Business Mailing Address
First Line	:	601 KING ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-2161
Country	:	US
Telephone Number	:	313-241-6154
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 BAGLEY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1990
Country	:	US
Telephone Number	:	313-241-6154
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARTER COMRIE
Credential	:	PHD
Telephone Number	:	313-241-6154

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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