Provider Demographics
NPI:1063937795
Name:SKELTON, HANNAH (LCAS, LCMHC-A)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:LCAS, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 N ONEIL ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-1806
Mailing Address - Country:US
Mailing Address - Phone:919-708-2232
Mailing Address - Fax:
Practice Address - Street 1:1699 OLD US 70 HWY W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-6566
Practice Address - Country:US
Practice Address - Phone:919-359-1699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-23492101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)