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NPI Code Detail

MEDICARE: JOSEPH P. SKELLY M.S., L.M.H.C.

MEDICARE: JOSEPH P. SKELLY M.S., L.M.H.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH0003140FL

General Provider Information

NPI Number : 1417901133
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH P. SKELLY M.S., L.M.H.C.
Provider Business Mailing Address
First Line : 151 MARY ESTHER BLVD
Second Line : SUITE 201
City : MARY ESTHER
State : FL
Zip : 32569-1972
Country : US
Telephone Number : 850-862-6030
Fax Number : 850-862-6030
Provider Business Practice Location Address
First Line : 151 MARY ESTHER BLVD
Second Line : SUITE 201
City : MARY ESTHER
State : FL
Zip : 32569-1972
Country : US
Telephone Number : 850-862-6030
Fax Number : 850-862-6030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 07/08/2007

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