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General NPI Number Information
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NPI Number | 1215439971
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Entity Type | Individual
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Provider Name | CHRISTOPHER PATRICK SCANLON LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 850-447-1279
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Fax |
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Provider Business Mailing Address
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Address Line | 3554 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 850-447-1279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW12264
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License Number State | FL
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