Provider Demographics
NPI:1285252494
Name:SCOLARO, ANNA (PSYD, LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SCOLARO
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:STONE RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12484-5612
Mailing Address - Country:US
Mailing Address - Phone:908-216-6845
Mailing Address - Fax:
Practice Address - Street 1:312 E 85TH ST APT 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4569
Practice Address - Country:US
Practice Address - Phone:646-484-9245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0876541041C0700X
NY026169103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical