Provider Demographics
NPI:1477025724
Name:ERICA R. SCIOLI PHD LLC
Entity Type:Organization
Organization Name:ERICA R. SCIOLI PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCIOLI-SALTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:857-207-0128
Mailing Address - Street 1:1415 BEACON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4819
Mailing Address - Country:US
Mailing Address - Phone:857-207-0128
Mailing Address - Fax:
Practice Address - Street 1:1415 BEACON ST STE 202
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4819
Practice Address - Country:US
Practice Address - Phone:857-207-0128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health