Brandy Michelle Skidmore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10927 Issued in LA

Practice address

601 Teema Rd
Carencro, LA 70520

Phone

(337) 521-7640

Fax

(337) 521-7641

NPI assigned

Sep 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Brandy Michelle George Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Revived and Renewed Mental Health, LLC

  • Adult Mental Health Clinic/Center
  • Lafayette, LA
  • NPI 1376151969
  NPD Authorized official

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1154722353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400A AMBASSADOR CAFFERY PKWY # 167",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086706",
            "telephone_number": "337-450-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TEEMA RD",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "70520",
            "telephone_number": "337-521-7640",
            "fax_number": "337-521-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "BRANDY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "10927",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "LA",
            "license": "10927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "GEORGE",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Silver Lining Adult Day Health Care LLC
• Katera Marie Simmons, CNA, PHLEBOTOMY,M.A
• Latoya N Simon, PCT
• Angelle Sion
• Hailey Sistrunk, BIRTH DOULA CD DONA
• Snyder Psychiatric Services, LLC
• Addie Snyder, PMHNP
• Southern Neuro Specialty
• Phillip Lyle Stelly, DDS
• Tia Strawder Kelly

• Clinical Social Worker in Carencro, LA
• Providers in Carencro, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.