Doctor Name: | MR. CARL ROY SCIANNA |
NPI Number: | 1043472624 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LCPC |
License Number: | 180.007794 |
Business Practice Address: | 1263 S Highland Ave Ste 2d Lombard, IL - 601484527 |
Business Phone Number: | 6304088108 |
Business Fax Number: | |
Mailing Address: | Po Box 4143, CHICAGO |
State: | IL |
Postal Code: | 606544143 |
Phone Number: | 6302907762 |
Fax Number: | |
NPI Enumeration Date: | 06/25/2008 |
NPI Last Update Date: | 05/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180.007794 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |