Provider Demographics
NPI:1568074805
Name:SCALESE, ADAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:SCALESE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 W 380 S
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2976
Mailing Address - Country:US
Mailing Address - Phone:808-492-6971
Mailing Address - Fax:
Practice Address - Street 1:216 W 380 S
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2976
Practice Address - Country:US
Practice Address - Phone:808-492-6971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11453692-2501103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling