MEDICARE: SHANNON CAROLINE SCOTT MS, LPC, NCC

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	101YP2500X	Professional Counselor	010953	PA

General Provider Information

NPI Number	:	1720550437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON CAROLINE SCOTT MS, LPC, NCC

Provider Business Mailing Address
First Line	:	5916 HOWE ST APT C2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-2830
Country	:	US
Telephone Number	:	412-849-9371
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 BOYCE RD STE 9
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-1541
Country	:	US
Telephone Number	:	412-254-8155
Fax Number	:

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

Provider Enumeration Date	:	12/19/2018
Last Update Date	:	12/19/2018

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