=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063316776
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANNETTE IBARRA SKEEN COUNSELING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2016 ASSEMBLY ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29201-2142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-250-1991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2016 ASSEMBLY ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29201-2142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-250-1991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, LPC
-----------------------------------------------------
Name | DR. ANNETTE IBARRA SKEEN
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 803-250-1991
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------