Healthcare Provider Details

I. General information

NPI: 1770384042
Provider Name (Legal Business Name): LAUREN SKELLY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CONGRESS ST STE 2235
SALEM MA
01970-5529
US

IV. Provider business mailing address

35 CONGRESS ST STE 2235
SALEM MA
01970-5529
US

V. Phone/Fax

Practice location:
  • Phone: 978-238-1870
  • Fax: 978-238-1844
Mailing address:
  • Phone: 978-238-1870
  • Fax: 978-238-1844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number828127
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2307595
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: