Skiwise LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SKIWISE LLC

Doing business as

SkiWise Health and Wellness Services

Practice address

449 N Euclid Ave
Saint Louis, MO 63108-1642

Phone

(314) 475-8532

NPI assigned

Apr 6, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Alicia D Buck

Title

Director

Phone

(341) 475-8532

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SkiWise Health and Wellness Services Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia D Buck Hall, LPC

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1740701374
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1003349051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 N EUCLID AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081642",
            "telephone_number": "314-475-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 N EUCLID AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081642",
            "telephone_number": "314-475-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIWISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "341-475-8532",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490051600",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500099408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SkiWise Health and Wellness Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derrick Skinner Sr., LCSW
• Kristina Camba Skinner, FNP
• Kyra Skinner, PA-C
• Regina Skinner, AA-C
• Krystal L Skipper, MA, LPC
• SKN PLLC
• Donald A Skor, MD
• Katie Corinne Skosky, FNP-C
• Raymond Joseph Skosky, DDS
• Danielle D Skouby, PHARM.D., BCPS

• Multi-Specialty Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Multi-Specialty Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.