Healthcare Provider Details

I. General information

NPI: 1477433134
Provider Name (Legal Business Name): DANIELLE MARIE SKELLY LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1295 OLD US 1 HWY STE B
SOUTHERN PINES NC
28387-6344
US

IV. Provider business mailing address

632 W PROSPECT AVE
RAEFORD NC
28376-2512
US

V. Phone/Fax

Practice location:
  • Phone: 910-725-0211
  • Fax: 910-725-0301
Mailing address:
  • Phone: 910-875-5590
  • Fax: 910-875-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number20852A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: