Scott J Scotilla, PSYD ICAADC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016517 Issued in PA

Practice address

1315 S Allen St Ste 303
State College, PA 16801-5923

Phone

(814) 867-2866

Fax

(866) 283-4558

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scotilla Psychological Services LLC

  • Clinical Psychologist
  • State College, PA
  • NPI 1861711939

  Addiction (Substance Use Disorder)

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1043437908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10910",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168050910",
            "telephone_number": "814-867-2866",
            "fax_number": "866-283-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S ALLEN ST STE 303",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015923",
            "telephone_number": "814-867-2866",
            "fax_number": "866-283-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTILLA",
        "first_name": "SCOTT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSYD ICAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016517",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "7050",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016799",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "PS016517",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "PA",
            "license": "PS016517",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "PA",
            "license": "PS016517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scott@scotilla.com",
            "affiliation": "N",
            "endpointDescription": "secure encrypted business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1315 S Allen St Ste 303",
            "city": "State College",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168015923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffery Robert Scipione, D.C
• John Scipione, D.C.
• John L Scipione, D.C.
• Timothy Jude Sciullo, D.C.
• Scotilla Psychological Services LLC
• Heather S Scott, PHD
• Alyssa Sebastianelli, NP
• Hannah Jinhee Sebold, PA-C
• Cory D Sefchick, PA-C
• Lynnette Sefchick

• Clinical Psychologist in State College, PA
• Providers in State College, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.