MEDICARE: DR. CHARLESETTA SHELTON SCOTT M.D.

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	2084P0804X	Child & Adolescent Psychiatry Physician	036.120082	IL
2	2084P0804X	Child & Adolescent Psychiatry Physician	032472	GA

General Provider Information

NPI Number	:	1285752196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLESETTA SHELTON SCOTT M.D.

Provider Business Mailing Address
First Line	:	317 WOODWARD AVE SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-2123
Country	:	US
Telephone Number	:	404-432-1531
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 WOODWARD AVE SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-2123
Country	:	US
Telephone Number	:	404-432-1531
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	08/02/2012

Similar Medicare Providers

1194823716 — MS. KATHRYN RENEE MARLOW LCSW
Practice Location Address:

2123 S ATLANTA PL , STE 150
TULSA, OK
74114-1779

Practice Phone: 918-749-6838
Practice Fax: 833-752-0014

1235495870 — DR. SEAN MARK KRAHENBUHL D.O.
Practice Location Address:

2123 S ATLANTA PL STE 200
TULSA, OK
74114-1780

Practice Phone: 918-630-2665
Practice Fax:

1518202167 — ALEKSANDRA RAKITA-JEREMIC MS, LPC, NCC
Practice Location Address:

2964 PEACHTREE RD NW STE 620
ATLANTA, GA
30305-2123

Practice Phone: 404-735-5483
Practice Fax:

1578964979 — DR. ADAM MCTIGHE PSY.D., MBA
Practice Location Address:

3545 BROAD ST UNIT 660156
ATLANTA, GA
30366-2123

Practice Phone: 404-275-4604
Practice Fax:

1619753274 — MIND RESTORATION, LLC
Practice Location Address:

3545 BROAD ST UNIT 660156
ATLANTA, GA
30366-2123

Practice Phone: 404-275-4604
Practice Fax:

1821654617 — CONNOR JAMES BUTZ PHYSICIAN ASSISTANT
Practice Location Address:

659 AUBURN AVE NE STE 156
ATLANTA, GA
30312-1976

Practice Phone: 404-888-0228
Practice Fax: 833-941-5100

Directions to “ DR. CHARLESETTA SHELTON SCOTT M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.