MEDICARE: JASON SHANE SCAMARDO LPC

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	101YM0800X	Mental Health Counselor	8355	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336654144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON SHANE SCAMARDO LPC

Provider Business Mailing Address
First Line	:	8127 BIRCH ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-2819
Country	:	US
Telephone Number	:	504-358-8218
Fax Number	:

Provider Business Practice Location Address
First Line	:	8127 BIRCH ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-2819
Country	:	US
Telephone Number	:	504-358-8218
Fax Number	:

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

Provider Enumeration Date	:	12/04/2017
Last Update Date	:	01/26/2024

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