Provider Demographics
NPI:1699242313
Name:SKELTON COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:SKELTON COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKELTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-506-5171
Mailing Address - Street 1:2505 KIRBY ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-1831
Mailing Address - Country:US
Mailing Address - Phone:505-506-5171
Mailing Address - Fax:
Practice Address - Street 1:754 PATTON DR
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4784
Practice Address - Country:US
Practice Address - Phone:505-506-5171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health