MEDICARE: MR. JOSEF SCOTT YORK

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	IC-460	NV

General Provider Information

NPI Number	:	1659447795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEF SCOTT YORK

Provider Business Mailing Address
First Line	:	864 WATERLOO DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-9564
Country	:	US
Telephone Number	:	702-987-3195
Fax Number	:	702-486-7522

Provider Business Practice Location Address
First Line	:	3075 E FLAMINGO RD
Second Line	:	SUITE 108
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7483
Country	:	US
Telephone Number	:	702-486-7532
Fax Number	:	702-486-7522

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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