Scoglio-Walsh, Jaclyn Virginia

Scoglio-Walsh, Jaclyn Virginia is an sole proprietor health care provider with primary practice located at 887 Old Country Rd Suite D, Riverhead NY 11901-2115. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Scoglio-Walsh, Jaclyn Virginia can be contacted via phone (631) 727-6056.

Contact Information

Primary practice address
887 Old Country Rd Suite D Riverhead NY 11901-2115
Phone: (631) 727-6056
Fax: (631) 727-1326
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 074791 New York

Profile Details

NPI number 1639394174
LBN Legal business name Scoglio-Walsh, Jaclyn Virginia
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 17th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639394174 NPPES
New York Other 197150P HIP PROVIDER NUMBER
New York Other P3152242 HIP PROVIDER NUMBER

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