=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467399816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INNER WORTH MENTAL HEATH COUSNELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3769 PARRIS BRIDGE RD
-----------------------------------------------------
City | BOILING SPRINGS
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29316-5411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-960-2153
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2441 31ST ST # 1151
-----------------------------------------------------
City | ASTORIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11102-1140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-764-5044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER-MANAGER
-----------------------------------------------------
Name | ELLIOTT DALTON SKAGGS
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 917-960-2153
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------