Provider Demographics
NPI:1124022678
Name:LA SCALA, DENNIS F (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:F
Last Name:LA SCALA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WARD PL
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5008
Mailing Address - Country:US
Mailing Address - Phone:973-364-9613
Mailing Address - Fax:
Practice Address - Street 1:14 SMULL AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5012
Practice Address - Country:US
Practice Address - Phone:973-226-5521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2009-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00384100103TF0000X
NJ00069899103TS0200X
NJ37FI00158000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist