Provider Demographics
NPI:1699217349
Name:SKILLMAN, JOCELYN (LMHC, MHP, CMHS)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:SKILLMAN
Suffix:
Gender:F
Credentials:LMHC, MHP, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 RAINIER BLVD N
Mailing Address - Street 2:SUITE 21B
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2806
Mailing Address - Country:US
Mailing Address - Phone:425-985-2657
Mailing Address - Fax:
Practice Address - Street 1:545 RAINIER BLVD N
Practice Address - Street 2:SUITE 21B
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2806
Practice Address - Country:US
Practice Address - Phone:425-985-2657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60677348101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health