Healthcare Provider Details

I. General information

NPI: 1942658265
Provider Name (Legal Business Name): ADRIENNE SKARIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 OLIVE ST SUITE #500
SAINT LOUIS MO
63103-2303
US

IV. Provider business mailing address

8949 MANCHESTER RD
BRENTWOOD MO
63144-2621
US

V. Phone/Fax

Practice location:
  • Phone: 314-719-9129
  • Fax:
Mailing address:
  • Phone: 329-432-6314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2021051201
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: