Provider Demographics
NPI:1598365207
Name:SCALA, JOHN WESLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name: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 1:474 WINDMERE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7651
Mailing Address - Country:US
Mailing Address - Phone:814-208-9248
Mailing Address - Fax:814-208-9109
Practice Address - Street 1:474 WINDMERE DR STE 301
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7651
Practice Address - Country:US
Practice Address - Phone:814-208-9248
Practice Address - Fax:814-208-9109
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019142103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist