MEDICARE: CHRISTOPHER SCOVILLE LCSW, LCAS

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	C014860	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-25618	NC

General Provider Information

NPI Number	:	1982295424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER SCOVILLE LCSW, LCAS

Provider Business Mailing Address
First Line	:	104 NEW STATESIDE DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-1213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 NEW STATESIDE DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-1213
Country	:	US
Telephone Number	:	919-942-2803
Fax Number	:

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

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	11/25/2025

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