MEDICARE: DR. STEVEN ROBERT SCALLY JR. PHD

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	103TC1900X	Counseling Psychologist	NA	IN

General Provider Information

NPI Number	:	1386588861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN ROBERT SCALLY JR. PHD

Provider Business Mailing Address
First Line	:	8930 WARWICK CASTLE LN APT 1023
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-5611
Country	:	US
Telephone Number	:	219-869-4131
Fax Number	:

Provider Business Practice Location Address
First Line	:	8202 CLEARVISTA PKWY STE 6D
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1442
Country	:	US
Telephone Number	:	219-869-4131
Fax Number	:

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

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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