Provider Demographics
NPI:1083765580
Name:CARLSON, SCOTT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:CARLSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 ROCKHILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1411
Mailing Address - Country:US
Mailing Address - Phone:412-319-7148
Mailing Address - Fax:
Practice Address - Street 1:300 ROCKFIELD CIR
Practice Address - Street 2:WPIC-BT4
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1406
Practice Address - Country:US
Practice Address - Phone:412-246-5407
Practice Address - Fax:412-246-5410
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008542L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical