Healthcare Provider Details

I. General information

NPI: 1891591640
Provider Name (Legal Business Name): JODIE SKOFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 RUFFIN ST
DURHAM NC
27701-1215
US

IV. Provider business mailing address

1420 RUFFIN ST
DURHAM NC
27701-1215
US

V. Phone/Fax

Practice location:
  • Phone: 919-672-2986
  • Fax:
Mailing address:
  • Phone: 919-672-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004669
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: