MEDICARE: MS. SHARRON LIVINGSTON SKAGGS RN C LCDC

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
1	364SP0812X	Community Psychiatric/Mental Health Clinical Nurse Specialist	03055	TX

General Provider Information

NPI Number	:	1740360817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARRON LIVINGSTON SKAGGS RN C LCDC

Provider Business Mailing Address
First Line	:	1433 FAIRFIELD DR
Second Line	:	HILL COUNTRY COUNSELING
City	:	AUSTIN
State	:	TX
Zip	:	78758
Country	:	US
Telephone Number	:	512-491-8444
Fax Number	:	512-491-0226

Provider Business Practice Location Address
First Line	:	1433 FAIRFIELD DR
Second Line	:	HILL COUNTRY COUNSELING
City	:	AUSTIN
State	:	TX
Zip	:	78758
Country	:	US
Telephone Number	:	512-491-8444
Fax Number	:	512-491-0226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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