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General NPI Number Information
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NPI Number | 1699242313
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Entity Type | Organization
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Legal Business Name | SKELTON COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 754 PATTON DR
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City | GALLUP
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State | NM
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Zip | 87301-4784
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Country | US
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Telephone | 505-506-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 2505 KIRBY ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-1831
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Country | US
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Telephone | 505-506-5171
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JULIE SKELTON
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Credential | LCSW
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Telephone | 505-506-5171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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