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Contact Information

THERESA E SCULLY, LICSW
125 MAIN ST; UNIT 220
WILLISTON, ND58801
 Phone: 701-570-4602
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for THERESA E SCULLY · (Female)

NPI # 1316485634
Status Active
Credentials LICSW (Licensed Independent Clinical Social Worker)
Entity Individual
Enumeration date 02/07/2017
Last updated 02/07/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • ND License # 4970
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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