Provider Demographics
NPI:1447012034
Name:SCULLY, PAMELA
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:SCULLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STEPPINGSTONE, INC. - SOAR OUT-PATIENT
Mailing Address - Street 2:5 DOVER ST, SUITE 201
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740
Mailing Address - Country:US
Mailing Address - Phone:508-984-4155
Mailing Address - Fax:508-994-4155
Practice Address - Street 1:STEPPINGSTONE, INC. - SOAR OUT-PATIENT
Practice Address - Street 2:5 DOVER ST, SUITE 201
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:508-984-4155
Practice Address - Fax:508-994-4155
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)