Provider Demographics
NPI:1316193840
Name:SCOTT C. WINDHAM, LCSW PC
Entity Type:Organization
Organization Name:SCOTT C. WINDHAM, LCSW PC
Other - Org Name:WINDHAM & LEIBOVICH PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:WINDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-561-0311
Mailing Address - Street 1:1016 GREENTREE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3100
Mailing Address - Country:US
Mailing Address - Phone:412-561-0311
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:412-561-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW015984101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty