Provider Demographics
NPI:1245534700
Name:SCOTT, RICHARD (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N WOOD RD
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966-6290
Mailing Address - Country:US
Mailing Address - Phone:618-262-0747
Mailing Address - Fax:618-615-4438
Practice Address - Street 1:1400 N WOOD RD
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-6290
Practice Address - Country:US
Practice Address - Phone:618-262-0747
Practice Address - Fax:618-615-4438
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009132103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist