Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

SCOTT GARLON WILLOUGHBY PHD
NPI 1699718635
Psychologist - Clinical in Hattiesburg, MS

Active since June 14, 2006Opted out of Medicare · through Jan 1, 2028
1 LINCOLN PARKWAY, SUITE 202, HATTIESBURG, MS 39402(601) 288-8050 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Scott Garlon Willoughby Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SCOTT GARLON WILLOUGHBY PHD (NPI 1699718635) is an individual clinical provider in Hattiesburg, Mississippi, licensed in Mississippi (41003) and active in the NPI registry since June 2006. He has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1699718635
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameSCOTT GARLON WILLOUGHBYCredential: PHD
Location Address1 LINCOLN PARKWAY, SUITE 202Hattiesburg, MS 39402
Mailing Address1 Lincoln Parkway, Suite 202Hattiesburg, MS 39402 · (601) 288-8050
Sole ProprietorNo
Enumeration DateJune 14, 2006
Last NPPES UpdateJuly 13, 2026
NPI 1699718635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in MS · 41003
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1 LINCOLN PARKWAY, Hattiesburg, MS 39402

Other Identifiers 1

Medicaid02351545MS

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Scott Garlon Willoughby Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2022 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2022
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
1 LINCOLN PARKWAY
HATTIESBURG, MS 39402
Clinic/Center (Pain)
1 LINCOLN PARKWAY, SUITE 106
HATTIESBURG, MS 39402
Nurse Practitioner (Psychiatric/Mental Health)
1 LINCOLN PARKWAY, SUITE 202
HATTIESBURG, MS 39402
Durable Medical Equipment & Medical Supplies (Customized Equipment)
1 LINCOLN PARKWAY, SUITE 100
HATTIESBURG, MS 39402
Psychiatry & Neurology (Psychiatry)
1 LINCOLN PARKWAY, SUITE 202
HATTIESBURG, MS 39402
Nurse Practitioner (Psychiatric/Mental Health)
1 LINCOLN PARKWAY, SUITE 202
HATTIESBURG, MS 39402
Psychiatry & Neurology (Psychiatry)
1 LINCOLN PARKWAY, SUITE 202
HATTIESBURG, MS 39402
Psychologist (Clinical)
1 LINCOLN PARKWAY, SUITE 202
HATTIESBURG, MS 39402

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699718635, enumerated as an "individual" on June 14, 2006.

The provider is located at 1 LINCOLN PARKWAY SUITE 202 HATTIESBURG, MS 39402 and the phone number is (601) 288-8050.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.