Healthcare Provider Details

I. General information

NPI: 1013096197
Provider Name (Legal Business Name): STEPHEN MICHAEL SCISCIONE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ROSE TREE LN
KENNETT SQUARE PA
19348-4118
US

IV. Provider business mailing address

601 ROSE TREE LN
KENNETT SQUARE PA
19348-4118
US

V. Phone/Fax

Practice location:
  • Phone: 610-925-0285
  • Fax:
Mailing address:
  • Phone: 610-925-0285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC000104
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC000104
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: