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NPI Code Detail

MEDICARE: NICHOLAS SKINNER

MEDICARE: NICHOLAS SKINNER
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1831319664
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS SKINNER
Provider Business Mailing Address
First Line : 700 SE CROSS ST
Second Line :
City : MOUNT STERLING
State : IL
Zip : 62353-1561
Country : US
Telephone Number : 217-773-3325
Fax Number : 217-773-2425
Provider Business Practice Location Address
First Line : 700 SE CROSS ST
Second Line :
City : MOUNT STERLING
State : IL
Zip : 62353-1561
Country : US
Telephone Number : 217-773-3325
Fax Number : 217-773-2425
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 10/25/2016

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Directions to “ NICHOLAS SKINNER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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