MEDICARE: MR. SCOTT STEPHEN TOMEY LLP

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	103TC0700X	Clinical Psychologist	6301017990	MI
2	103T00000X	Psychologist

General Provider Information

NPI Number	:	1790327328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT STEPHEN TOMEY LLP

Provider Business Mailing Address
First Line	:	23332 FARMINGTON RD # 204
Second Line	:
City	:	FARMINGTON
State	:	MI
Zip	:	48336-9991
Country	:	US
Telephone Number	:	734-469-8705
Fax Number	:

Provider Business Practice Location Address
First Line	:	23332 FARMINGTON RD # 204
Second Line	:
City	:	FARMINGTON
State	:	MI
Zip	:	48336-9991
Country	:	US
Telephone Number	:	734-469-8705
Fax Number	:

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

Provider Enumeration Date	:	10/15/2019
Last Update Date	:	11/06/2023

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