Jeff David Skillingstead, MAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60225625 Issued in WA

Practice address

1329 Broadway St
Suite 200
Longview, WA 98632-3747

Phone

(360) 431-6908

NPI assigned

Feb 14, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1609919562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 CEDARBROOK DR",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986329507",
            "telephone_number": "360-431-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 BROADWAY ST",
            "address_2": "SUITE 200",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323747",
            "telephone_number": "360-431-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILLINGSTEAD",
        "first_name": "JEFF",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60225625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajdeep Singh, MD
• Stephanie R Sipe, OD
• Genieve Sisson
• SJS, PLLC
• Andrew Levi Skillett
• Emily Skogrand, PHARMD
• Codi Slater, MS, LMHCA
• Janice Slaven, LPN
• David Slotte, RPH
• Randi Lynn Slotte, RPH

• Mental Health Counselor in Longview, WA
• Providers in Longview, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.