Provider Demographics
NPI:1093525990
Name:SKELTON, SAMANTHA BROOKE (LPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BROOKE
Last Name:SKELTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 HOWARTH DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-6010
Mailing Address - Country:US
Mailing Address - Phone:215-416-2148
Mailing Address - Fax:
Practice Address - Street 1:1620 HOWARTH DR
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-6010
Practice Address - Country:US
Practice Address - Phone:215-416-2148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health