Organization
SCOTILLA PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT J SCOTILLA PSYD ICAADC (OWNER/PSYCHOLOGIST)
(814) 867-2866
Entity
Organization
Contact information
Practice address
1315 S ALLEN ST STE 303, STATE COLLEGE, PA 16801-5923
(814) 867-2866
(866) 283-4558
Mailing address
PO BOX 10910, STATE COLLEGE, PA 16805-0910
(814) 867-2866
(866) 283-4558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PS016517
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS016517
PA
103TC0700X
Clinical Psychologist
Primary
PS016517
PA
103TF0200X
Forensic Psychologist
PS016517
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9683077
AETNA PIN
—
Enumeration date
05/27/2010
Last updated
01/11/2022
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