Healthcare Provider Details

I. General information

NPI: 1326957655
Provider Name (Legal Business Name): SKYLER ALEXANDRA MAKUCH LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 QUARRIER ST STE B
CHARLESTON WV
25301-6002
US

IV. Provider business mailing address

1313 QUARRIER ST STE B
CHARLESTON WV
25301-6002
US

V. Phone/Fax

Practice location:
  • Phone: 304-981-1412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1156
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: