Healthcare Provider Details

I. General information

NPI: 1952174104
Provider Name (Legal Business Name): SKYLAR HABERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SPRINGSIDE DR STE 350C
FAIRLAWN OH
44333-4536
US

IV. Provider business mailing address

7877 WILLOW CHASE BLVD
HOUSTON TX
77070-5934
US

V. Phone/Fax

Practice location:
  • Phone: 330-813-8396
  • Fax:
Mailing address:
  • Phone: 832-869-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: