Provider Demographics
NPI:1306503776
Name:SKIERSKI, DOUG (LPC)
Entity type:Individual
Prefix:
First Name:DOUG
Middle Name:
Last Name:SKIERSKI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-2802
Mailing Address - Country:US
Mailing Address - Phone:214-295-9295
Mailing Address - Fax:214-295-9317
Practice Address - Street 1:3015 MEDLIN DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2360
Practice Address - Country:US
Practice Address - Phone:214-295-9295
Practice Address - Fax:214-295-9317
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional