Skippergosh Therapy Licensed Clinical Social Worker Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SKIPPERGOSH THERAPY LICENSED CLINICAL SOCIAL WORKER INC

Practice address

5252 Balboa Ave Ste 800
San Diego, CA 92117-6970

Phone

(619) 404-0578

NPI assigned

Oct 7, 2022

Organization subpart

No

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

Authorized official

Name

Kristyne Skippergosh, LCSWNPI 1932550407

Title

Ceo

Phone

(616) 340-6820

Specialties & licenses 1

Addresses

Other names 1

• Skippergosh Therapy and Counseling Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristyne Skippergosh, ASW

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1932550407
  NPD Authorized official

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1760107114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 WESTSIDE DR APT 445",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081240",
            "telephone_number": "616-340-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176970",
            "telephone_number": "619-404-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIPPERGOSH THERAPY LICENSED CLINICAL SOCIAL WORKER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "SKIPPERGOSH",
        "authorized_official_first_name": "KRISTYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-340-6820",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skippergosh Therapy and Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Magdalene Elizabeth Skinner, BSW
• Nicole Jacaruso Skinner, PT
• Richard William Skinner, DO
• Taylor McKenzie Skinner
• Skintegration Management
• Kristyne Skippergosh, ASW
• Lynette Faye Skippon, CCC-SLP
• John Skirgaudas, MD
• Marc Benjamin Sklar, LAC, DA (RI)
• Nadav Rick Sklar, MFT

• Mental Health Clinic/Center (Including Community Mental Health Center) in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.