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NPI Code Detail

MEDICARE: EMILY SCARBOROUGH MSW, LCSW

MEDICARE: EMILY SCARBOROUGH MSW, LCSW
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
11041C0700XClinical Social Worker149.031308IL

General Provider Information

NPI Number : 1366398265
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY SCARBOROUGH MSW, LCSW
Provider Business Mailing Address
First Line : 4960 MIAMI ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-1216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1602 21ST ST
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-5397
Country : US
Telephone Number : 618-451-5722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/10/2026

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