Provider Demographics
NPI:1245926385
Name:KARCIE SCALLA, NOEL KATHERINE (MFT)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:KATHERINE
Last Name:KARCIE SCALLA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4368
Mailing Address - Country:US
Mailing Address - Phone:415-685-6604
Mailing Address - Fax:
Practice Address - Street 1:874 GRAVENSTEIN HIGHWAY SOUTH
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:94572
Practice Address - Country:US
Practice Address - Phone:415-638-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health