Provider Demographics
NPI:1467875872
Name:SCULLY, ANNE (ATR-BC, LCAT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:SCULLY
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 WHITE PLAINS RD STE 510
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5152
Mailing Address - Country:US
Mailing Address - Phone:914-345-5900
Mailing Address - Fax:
Practice Address - Street 1:300 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1810
Practice Address - Country:US
Practice Address - Phone:914-345-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00219221700000X
NY000219221700000X
NY001931106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000219OtherLCAT