Provider Demographics
NPI:1407872138
Name:SCIALLI, MARCIA GAYLE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:GAYLE
Last Name:SCIALLI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MARCIA
Other - Middle Name:REMAN
Other - Last Name:SCIALLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4647 N 32ND ST STE 260
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3344
Mailing Address - Country:US
Mailing Address - Phone:602-224-9888
Mailing Address - Fax:602-224-5304
Practice Address - Street 1:4647 N 32ND ST STE 260
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3344
Practice Address - Country:US
Practice Address - Phone:602-224-9888
Practice Address - Fax:602-224-5304
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-03441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical