Jessica Mae Scully, LCSW R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R047693-1 Issued in NY

Practice address

5 Knoll LN
Huntington Station, NY 11746-1337

Phone

(631) 421-4232

Fax

(631) 425-0221

NPI assigned

Oct 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1689862864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KNOLL LN",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461337",
            "telephone_number": "631-421-4232",
            "fax_number": "631-425-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 KNOLL LN",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461337",
            "telephone_number": "631-421-4232",
            "fax_number": "631-425-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "credential": "LCSW R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047693-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria L Schwartz, RDN
• Noreen M Scileppi, MA, CCC-LSP
• Scott Horowitz MD, PC
• Scott W Alpert MD PC
• Jennifer Anne Scott
• Diane Rosalie Seewald, R.N.
• Toby Seiden, LCSW
• Robert Dennis Seiler, PH.D.
• Brian Jeong Ho Seo
• Serenity Housing LLC

• Clinical Social Worker in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.