Provider Demographics
NPI:1023512845
Name:SCARBROUGH, NATHAN S (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:S
Last Name:SCARBROUGH
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-3900
Mailing Address - Country:US
Mailing Address - Phone:262-492-7467
Mailing Address - Fax:
Practice Address - Street 1:390 WATERLOO BLVD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2624
Practice Address - Country:US
Practice Address - Phone:262-492-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010254101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional