MEDICARE: MR. LEROY SCOTT LPC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	84794	TX
2	101Y00000X	Counselor	84794	TX
3	101YP2500X	Professional Counselor	84794	TX
4	101YM0800X	Mental Health Counselor	5965	FL

General Provider Information

NPI Number	:	1598799074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEROY SCOTT LPC

Provider Business Mailing Address
First Line	:	9212 FRY RD STE 105
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-5487
Country	:	US
Telephone Number	:	225-405-5895
Fax Number	:	281-846-6109

Provider Business Practice Location Address
First Line	:	2855 MANGUM RD STE A415
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-7493
Country	:	US
Telephone Number	:	225-405-5895
Fax Number	:	281-846-6109

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	10/03/2025

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