MEDICARE: J. SCOTT MCFADDEN, 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

General Provider Information

NPI Number	:	1649757840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. SCOTT MCFADDEN, LPC

Provider Business Mailing Address
First Line	:	PO BOX 76510
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80970-6510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1765 S 8TH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-7910
Country	:	US
Telephone Number	:	719-221-3452
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	J. SCOTT MCFADDEN
Credential	:	LPC
Telephone Number	:	719-221-3452

Provider Enumeration Date	:	07/20/2018
Last Update Date	:	07/20/2018

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