MEDICARE: MR. CEDRIC HARLAN SCOTT LIMITED LICENSE PSYC

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	103TA0400X	Addiction (Substance Use Disorder) Psychologist	200727	MI
2	103TC2200X	Clinical Child & Adolescent Psychologist
3	103T00000X	Psychologist	6301012964	MI

General Provider Information

NPI Number	:	1871605915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CEDRIC HARLAN SCOTT LIMITED LICENSE PSYC

Provider Business Mailing Address
First Line	:	2416 PECK ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49444-1431
Country	:	US
Telephone Number	:	231-733-6607
Fax Number	:	231-737-0534

Provider Business Practice Location Address
First Line	:	2416 PECK ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49444-1431
Country	:	US
Telephone Number	:	231-733-6607
Fax Number	:	231-737-0534

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/11/2025

Similar Medicare Providers

1972137883 — LAZARUSMAN CONSULTING, PLLC
Practice Location Address:

2416 PECK ST
MUSKEGON HTS, MI
49444-1431

Practice Phone: 231-747-6197
Practice Fax:

1982615357 — DR. AMY L DEAN D.O.
Practice Location Address:

1150 E SHERMAN BLVD STE 2400
MUSKEGON, MI
49444-1886

Practice Phone: 231-672-6336
Practice Fax: 231-672-6335

1356985675 — HEARING HEALTH USA-GENERAL, LLC
Practice Location Address:

1155 E SHERMAN BLVD
MUSKEGON, MI
49444-1809

Practice Phone: 973-588-7266
Practice Fax: 973-968-3983

1619629532 — MACKENZIE FAY FORD PA-C
Practice Location Address:

1500 E SHERMAN BLVD
MUSKEGON, MI
49444-1849

Practice Phone: 231-672-2000
Practice Fax:

1396435210 — MATTHEW EDWARD BARYLSKI DO
Practice Location Address:

1500 E SHERMAN BLVD
MUSKEGON, MI
49444-1849

Practice Phone: 231-672-6600
Practice Fax:

1285687145 — SHORELINE ASC, LLC
Practice Location Address:

1298 E SHERMAN BLVD
MUSKEGON, MI
49444-1831

Practice Phone: 231-737-4710
Practice Fax: 231-737-4711

Directions to “ MR. CEDRIC HARLAN SCOTT LIMITED LICENSE PSYC” 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 © 2007-2026 (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.