Provider Demographics
NPI:1992766406
Name:SCARLATA, STEVEN JOSEPH (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:SCARLATA
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USA MEDDAC
Mailing Address - Street 2:11050 MT. BELVEDERE BLVD.
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602-5004
Mailing Address - Country:US
Mailing Address - Phone:315-772-1074
Mailing Address - Fax:315-965-3279
Practice Address - Street 1:USA MEDDAC
Practice Address - Street 2:11050 MT BELVEDERE BLVD.
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602-5004
Practice Address - Country:US
Practice Address - Phone:315-772-1074
Practice Address - Fax:315-772-3279
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0763961041C0700X
NYR076396-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical