MEDICARE: SCOTT J ZANSKAS LMSW, LICSW

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	1041C0700X	Clinical Social Worker	LC50079789	DC
2	1041C0700X	Clinical Social Worker	6801090496	MI

General Provider Information

NPI Number	:	1598002404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT J ZANSKAS LMSW, LICSW

Provider Business Mailing Address
First Line	:	1125 15TH ST NW
Second Line	:	8TH FLOOR
City	:	WASHINGTON
State	:	DC
Zip	:	20005-2721
Country	:	US
Telephone Number	:	202-870-4720
Fax Number	:	202-730-1842

Provider Business Practice Location Address
First Line	:	1125 15TH ST NW
Second Line	:	8TH FLOOR
City	:	WASHINGTON
State	:	DC
Zip	:	20005-2721
Country	:	US
Telephone Number	:	202-870-4720
Fax Number	:	202-730-1842

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

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	07/24/2013

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