Healthcare Provider Details

I. General information

NPI: 1053070664
Provider Name (Legal Business Name): KARIN C SKINNER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 E 17TH ST
CHEYENNE WY
82001-4716
US

IV. Provider business mailing address

2500 DELL RANGE BLVD
CHEYENNE WY
82009-5273
US

V. Phone/Fax

Practice location:
  • Phone: 307-635-1223
  • Fax:
Mailing address:
  • Phone: 307-640-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2563
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: