Provider Demographics
NPI:1245942812
Name:SCULL, NICHOLAS C (PHD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:C
Last Name:SCULL
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 1:9 ARGYLE AVE
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-1055
Mailing Address - Country:US
Mailing Address - Phone:617-480-2799
Mailing Address - Fax:
Practice Address - Street 1:9 ARGYLE AVE
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-1055
Practice Address - Country:US
Practice Address - Phone:617-480-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0165121041C0700X
MAMA11533103TC1900X
RIPS01188103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical