Healthcare Provider Details

I. General information

NPI: 1467399816
Provider Name (Legal Business Name): ELLIOTT DALTON SKAGGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 09/10/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 POPLAR CREEK DRIVE
ASHEVILLE NC
28805
US

IV. Provider business mailing address

1280 LEXINGTON AVE FRNT 2 PMB #1044
NEW YORK NY
10028-2136
US

V. Phone/Fax

Practice location:
  • Phone: 917-960-2153
  • Fax:
Mailing address:
  • Phone: 917-960-2153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELLIOTT DALTON SKAGGS
Title or Position: SOLE PROPRIETOR
Credential: LMHC-D, LCMHC, LPC
Phone: 917-960-2153