Provider Demographics
NPI:1104299460
Name:SKAHILL, REBEKAH (LCMHC12145)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:SKAHILL
Suffix:
Gender:F
Credentials:LCMHC12145
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:
Other - Last Name:SKAHILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1814 BLOOMSBURY RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-9612
Mailing Address - Country:US
Mailing Address - Phone:252-943-5265
Mailing Address - Fax:
Practice Address - Street 1:1035C DIRECTOR CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5996
Practice Address - Country:US
Practice Address - Phone:252-943-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21920101Y00000X, 101YA0400X, 101YM0800X
101YM0800X
NC12145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1104299460Medicaid