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NPI Code Detail

MEDICARE: MARY ANNE SCOLLAN LCSW

MEDICARE: MARY ANNE SCOLLAN LCSW
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
11041C0700XClinical Social WorkerR048144NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P010048144OTHERNYBLUE CHOICE/RIPA
2110642OTHERNYPREFERRED CARE

General Provider Information

NPI Number : 1548240708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANNE SCOLLAN LCSW
Provider Business Mailing Address
First Line : 2290 EAST AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14610-2518
Country : US
Telephone Number : 585-261-6979
Fax Number :
Provider Business Practice Location Address
First Line : 2290 EAST AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14610-2518
Country : US
Telephone Number : 585-261-6979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2006
Last Update Date : 08/02/2010

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Directions to “ MARY ANNE SCOLLAN LCSW” Practice Location

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