MEDICARE: SKELETON KEY COUNSELING LLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831879238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKELETON KEY COUNSELING LLC

Provider Business Mailing Address
First Line	:	8468 LAKE JANE TRL N
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-9206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8468 LAKE JANE TRL N
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-9206
Country	:	US
Telephone Number	:	763-327-1118
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIC STEFAN SCHUCK
Credential	:	LPCC
Telephone Number	:	763-327-1118

Provider Enumeration Date	:	07/20/2023
Last Update Date	:	07/20/2023

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Directions to “SKELETON KEY COUNSELING LLC ” Practice Location

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