Active NPI
David Scully, LCSW
- Clinical Social Worker
- Albany, OR
National Provider Identifier
1932421203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3795
- Practice address
- 445 3Rd Ave SW
Albany, OR 97321-2272 - Phone
- (541) 967-3866
- Fax
- (541) 928-3020
- NPI assigned
- Feb 26, 2010
- Last updated
- Feb 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L3795 | OR | Primary |
Addresses
Primary practice location
445 3Rd Ave SW
Albany, OR 97321-2272
Mailing address
586 E Oak St
Lebanon, OR 97355-4441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3795 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267142400000",
"number": "1932421203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "586 E OAK ST",
"city": "LEBANON",
"state": "OR",
"postal_code": "973554441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 3RD AVE SW",
"city": "ALBANY",
"state": "OR",
"postal_code": "973212272",
"telephone_number": "541-967-3866",
"fax_number": "541-928-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCULLY",
"first_name": "DAVID",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-26",
"last_updated": "2010-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.