Provider Demographics
NPI:1881170934
Name:SCALONE FINTON, LAURA M (LICSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:M
Last Name:SCALONE FINTON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PORTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559-1929
Mailing Address - Country:US
Mailing Address - Phone:774-521-9664
Mailing Address - Fax:
Practice Address - Street 1:874 GIFFORD STREET EXT
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2952
Practice Address - Country:US
Practice Address - Phone:774-521-9664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1179611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical