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NPI Code Detail

MEDICARE: MATTHEW WALTER SKINNER LMSW

MEDICARE: MATTHEW WALTER SKINNER LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerLMSW-17284AZ

General Provider Information

NPI Number : 1184873408
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW WALTER SKINNER LMSW
Provider Business Mailing Address
First Line : 5777 E MAYO BLVD
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-4502
Country : US
Telephone Number : 480-342-2000
Fax Number :
Provider Business Practice Location Address
First Line : 5777 E MAYO BLVD
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-4502
Country : US
Telephone Number : 480-342-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2008
Last Update Date : 05/28/2026

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