Healthcare Provider Details

I. General information

NPI: 1982225413
Provider Name (Legal Business Name): YAMY SKOCEN PSYCHOTHERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YAMY HITCHCOCK YAMY HITCHCOCK

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 11/27/2023
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 SUMMER HAWK DR APT Y145
LONGMONT CO
80504-8828
US

IV. Provider business mailing address

805 SUMMER HAWK DR APT Y145
LONGMONT CO
80504-8828
US

V. Phone/Fax

Practice location:
  • Phone: 303-219-3295
  • Fax:
Mailing address:
  • Phone: 303-219-3295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0110496
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: