Provider Demographics
NPI:1922208859
Name:JOHANNA SCAGLIONE, PH.D.,LCSW
Entity Type:Organization
Organization Name:JOHANNA SCAGLIONE, PH.D.,LCSW
Other - Org Name:CMS CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCAGLIONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:434-738-7562
Mailing Address - Street 1:300 SPRINGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3031
Mailing Address - Country:US
Mailing Address - Phone:434-738-7562
Mailing Address - Fax:
Practice Address - Street 1:207 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-3112
Practice Address - Country:US
Practice Address - Phone:434-738-7562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05177000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health