Provider Demographics
NPI:1598118242
Name:STEVEN G SCLAN, PH.D., PA
Entity Type:Organization
Organization Name:STEVEN G SCLAN, PH.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER; PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCLAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:904-639-6999
Mailing Address - Street 1:221 N HOGAN ST
Mailing Address - Street 2:234
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-4201
Mailing Address - Country:US
Mailing Address - Phone:904-639-6999
Mailing Address - Fax:
Practice Address - Street 1:221 N HOGAN ST
Practice Address - Street 2:234
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-4201
Practice Address - Country:US
Practice Address - Phone:904-639-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6845103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty