Kelli P Skoog, M.A., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3416 Issued in MN

Practice address

1114 Grand Ave
Saint Paul, MN 55105-2628

Phone

(612) 444-1890

NPI assigned

Jan 14, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1407212806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 2ND AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232411",
            "telephone_number": "612-581-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052628",
            "telephone_number": "612-444-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOOG",
        "first_name": "KELLI",
        "middle_name": "P",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3416",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "Z096253359215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Sklader, RN, CRNA
• Chrystin Mary Skog, PA-C
• Jacqueline J Skog, M.A.
• Skon Chiropractic PA
• William Henry Skon, D.C.
• Allanna Skoogman
• Mary E Skorczeski, CNM
• Maciej Skorupski, PA
• Jacorey Skottmyhre, LADC
• Joseph I Skow, MD

• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.