Healthcare Provider Details

I. General information

NPI: 1700522810
Provider Name (Legal Business Name): SERENA SKIEF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 W HOLMES RD STE 200
LANSING MI
48910-0411
US

IV. Provider business mailing address

3921 HUNTERS RIDGE DR APT 1
LANSING MI
48911-1109
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-0026
  • Fax:
Mailing address:
  • Phone: 517-899-5062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: