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General NPI Number Information
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NPI Number | 1831322759
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Entity Type | Individual
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Provider Name | KERRI SCULLY LPC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 135 WESTERVELT AVE.
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City | HAWTHORNE
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State | NJ
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Zip | 07506
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Country | US
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Telephone | 973-963-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 135 WESTERVELT AVE
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City | HAWTHORNE
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State | NJ
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Zip | 07506-3753
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Country | US
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Telephone | 973-963-4156
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00386000
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License Number State | NJ
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