Active NPI
Kayla Skinner, PHD
- Clinical Psychologist
- Maryland Heights, MO
National Provider Identifier
1700383114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2020026173
- Practice address
- 2458 Old Dorsett Rd Ste 110
Maryland Heights, MO 63043-2423 - Phone
- (636) 939-2550
- Fax
- (636) 939-2551
- NPI assigned
- Apr 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810006291 | VA | |
| Clinical Psychologist | 103TC0700X | 2020026173 | MO | Primary |
Addresses
Primary practice location
2458 Old Dorsett Rd Ste 110
Maryland Heights, MO 63043-2423
Mailing address
PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5888
Other practice location 1
825 Fairfax Ave Ste 710
Norfolk, VA 23507-1912
Phone (757) 446-5888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020026173 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1700383114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235010936",
"telephone_number": "757-446-5888",
"fax_number": "757-446-5918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2458 OLD DORSETT RD STE 110",
"city": "MARYLAND HEIGHTS",
"state": "MO",
"postal_code": "630432423",
"telephone_number": "636-939-2550",
"fax_number": "636-939-2551"
}
],
"practiceLocations": [
{
"address_1": "825 Fairfax Ave Ste 710",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "235071912",
"country_code": "US",
"telephone_number": "757-446-5888",
"fax_number": "757-446-5918",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKINNER",
"first_name": "KAYLA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-11",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810006291",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2020026173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryland Heights, MO
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- Mariah Rose Sindel, SLPA
- Jeanie Skiff, CPHT
- Rebecca Marie Smith, RN
- Eric Snyder, D.D.S.
- Ryan Bradley Sondergard, D.O.
- Karen Michelle Spengel, LPC
- Spinal Care Concepts, P.C. (McKelvey Chiropractic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.