Individual provider Active NPI

Abby Jo Skender, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clinton TWP, MI
National Provider Identifier
1255977906
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704317555NSA22036 Issued in MI
Practice address
42815 Garfield Rd Ste 210
Clinton TWP, MI 48038-1143
Phone
(586) 846-4835
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704317555 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704317555NSA22036 MI Primary

Addresses

Primary practice location

42815 Garfield Rd Ste 210
Clinton TWP, MI 48038-1143

Mailing address

42815 Garfield Rd Ste 210
Clinton TWP, MI 48038-1143
Phone (586) 846-4835

Other practice location 1

10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (313) 375-7031

Other names 1

  • Ms. Abby Jo Aguinaga Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260427001622 MI Practitioner - Nurse Practitioner 3678040797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baddigam Family Psychiatric Associates PLLCGroup PAC ID 7719911742, 5 clinicians

Practice addresses (Care Compare)

43211 Dalcoma Dr
Suite 3
Clinton Township, MI 48038-6309
Phone (586) 263-6812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
4704317555MIMDRegistered Nurse
4704317555NSA22036MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Therapeutic Partners, LLC CurrentSince Feb 13, 2022 Accepting new patients

Locations

42815 Garfield Rd
Ste 210
Clinton Twp, MI 48038
Phone (586) 212-8218

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1255977906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD STE 210",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-846-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD STE 210",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-846-4835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Taylor",
            "state": "MI",
            "postal_code": "481803330",
            "country_code": "US",
            "telephone_number": "313-375-7031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKENDER",
        "first_name": "ABBY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704317555",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704317555NSA22036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "AGUINAGA",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "MSN, APRN, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.