Provider Demographics
NPI:1194887513
Name:SKOVLUND, CHAR (LPC-MH, CCDCIII)
Entity type:Individual
Prefix:
First Name:CHAR
Middle Name:
Last Name:SKOVLUND
Suffix:
Gender:F
Credentials:LPC-MH, CCDCIII
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:
Other - Last Name:SKOVLUND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-MH, CCDCIII
Mailing Address - Street 1:4400 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8170
Mailing Address - Country:US
Mailing Address - Phone:605-322-4079
Mailing Address - Fax:605-322-4080
Practice Address - Street 1:4400 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8170
Practice Address - Country:US
Practice Address - Phone:605-322-4079
Practice Address - Fax:605-322-4080
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCCDCIII -05111241101YA0400X
SDLPC-MH2157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health