Provider Demographics
NPI:1215717848
Name:SKINULIS, NATALIE (LPC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:SKINULIS
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 1:2274 JET STREAM DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-8828
Mailing Address - Country:US
Mailing Address - Phone:170-859-5367
Mailing Address - Fax:
Practice Address - Street 1:21 S WHITE ST STE 3
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-4007
Practice Address - Country:US
Practice Address - Phone:815-662-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional