Healthcare Provider Details

I. General information

NPI: 1427714807
Provider Name (Legal Business Name): STEPHANIE MARIE SCACCIA X LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 NEW KARNER RD
ALBANY NY
12205-3852
US

IV. Provider business mailing address

427 NEW KARNER RD
ALBANY NY
12205-3852
US

V. Phone/Fax

Practice location:
  • Phone: 585-442-8422
  • Fax:
Mailing address:
  • Phone: 585-532-0829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number104985
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: