Provider Demographics
NPI:1083133623
Name:SCOLLIONE, JAMES (PHD, LCDC III)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:SCOLLIONE
Suffix:
Gender:
Credentials:PHD, LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 YOUNGSTOWN RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5002
Mailing Address - Country:US
Mailing Address - Phone:330-369-8022
Mailing Address - Fax:330-984-4270
Practice Address - Street 1:2737 YOUNGSTOWN RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5002
Practice Address - Country:US
Practice Address - Phone:330-369-8022
Practice Address - Fax:330-984-4270
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2025-05-09
Deactivation Date:2022-06-09
Deactivation Code:
Reactivation Date:2025-05-09
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.162688101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0260710Medicaid