MEDICARE: MELINA SCALLY PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY9480	FL
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1003171257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINA SCALLY PSY.D.

Provider Business Mailing Address
First Line	:	608 MERES BLVD
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-2632
Country	:	US
Telephone Number	:	407-432-8743
Fax Number	:

Provider Business Practice Location Address
First Line	:	2611 KEYSTONE RD
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-7403
Country	:	US
Telephone Number	:	407-432-8743
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2012
Last Update Date	:	10/30/2025

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