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NPI 1730403460

NPI 1730403460 : SCOTT P. PRANIS LMSW : SENECA FALLS, NY

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General NPI Number Information
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    NPI Number           |    1730403460
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT P. PRANIS LMSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2010
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    Last Update Date     |    03/24/2010
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Provider Practice Location Address
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    Address Line         |    12 N PARK ST SECOND FLOOR
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    City                 |    SENECA FALLS
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    State                |    NY
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    Zip                  |    13148-1437
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    Country              |    US
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    Telephone            |    315-568-9412
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    Fax                  |    315-568-6718
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Provider Business Mailing Address
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    Address Line         |    12 N PARK ST 2ND FLOOR
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    City                 |    SENECA FALLS
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    State                |    NY
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    Zip                  |    13148-1437
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    Country              |    US
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    Telephone            |    315-568-9412
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    Fax                  |    315-568-6718
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    077019
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    License Number State |    NY
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