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General NPI Number Information
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NPI Number | 1881576072
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Entity Type | Organization
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Legal Business Name | SCKIC, INC.
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 1175 10TH ST
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City | DES MOINES
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State | IA
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Zip | 50314-2208
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Country | US
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Telephone | 515-954-9413
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 57672
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City | DES MOINES
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State | IA
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Zip | 50317-0011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF DEVELOPMENT
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Name | AUSTIN STUBBS
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Credential |
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Telephone | 515-954-9413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #7
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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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