Flynn Skidmore, M.ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

704 Catharine St
Philadelphia, PA 19147-2812

Phone

(917) 215-9758

NPI assigned

Jun 10, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1386203743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 E PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472924",
            "telephone_number": "917-215-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CATHARINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472812",
            "telephone_number": "917-215-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "FLYNN",
        "credential": "M.ED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "flynn@movemindbody.co",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "704 Catharine St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191472812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Brooke Skelton, LPC
• Sonela Skenderi, D.O
• Bartosz Skiba, DO
• Justin Skiba, MD
• Christopher T. Skidmore, M.D.
• Valerie Theresa Skiendzielewski, D.D.S.
• Eileen T. Skiffington, APN
• Ora J Skiles, CRNA
• Skills Path Therapy
• Skillzrus

• Mental Health Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.