Provider Demographics
NPI:1265723928
Name:MCNALLY, SCOTT (LICSW)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MCNALLY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 MAGAZINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-4016
Mailing Address - Country:US
Mailing Address - Phone:413-218-9304
Mailing Address - Fax:413-382-7119
Practice Address - Street 1:153 MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-4016
Practice Address - Country:US
Practice Address - Phone:413-218-9304
Practice Address - Fax:413-382-7119
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0078181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical