Provider Demographics
NPI:1013178771
Name:WINDHAM, SCOTT CARTER (LCSW)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:CARTER
Last Name:WINDHAM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CONESTOGA DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1954
Mailing Address - Country:US
Mailing Address - Phone:724-331-5181
Mailing Address - Fax:412-561-0511
Practice Address - Street 1:1016 GREENTREE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3100
Practice Address - Country:US
Practice Address - Phone:412-561-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159841041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical