MEDICARE: SCOTT C. WINDHAM, LCSW PC

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	251S00000X	Community/Behavioral Health Agency	CW015984	PA
2	101YM0800X	Mental Health Counselor	CW015984	PA

General Provider Information

NPI Number	:	1316193840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT C. WINDHAM, LCSW PC

Provider Business Mailing Address
First Line	:	1016 GREENTREE RD
Second Line	:	SUITE 102
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-3100
Country	:	US
Telephone Number	:	412-561-0311
Fax Number	:	412-561-0511

Provider Business Practice Location Address
First Line	:	1016 GREENTREE RD
Second Line	:	SUITE 102
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-3100
Country	:	US
Telephone Number	:	412-561-0311
Fax Number	:	412-561-0511

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SCOTT CARTER WINDHAM
Credential	:	LCSW
Telephone Number	:	412-561-0311

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	05/05/2015

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