Cecilia Mae Skidmore, M.A., L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401001787 Issued in MI

Practice address

2288 Dean Lake Ave NE
Grand Rapids, MI 49505-4445

Phone

(313) 443-7581

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Third Coast Counseling Center

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1841387099
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1760533632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2288 DEAN LAKE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054445",
            "telephone_number": "313-443-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 DEAN LAKE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054445",
            "telephone_number": "313-443-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "CECILIA",
        "middle_name": "MAE",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401001787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR LICENSE",
            "identifier": "6401001767",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SJR Therapy PLLC
• Christina Skammel
• Sarah Rosanne Skavnak, NP
• Ketzel Skazalski
• Kyleigh Kay Skedgell, PHD
• Ronald Craig Skidmore, MA, MA, MDIV, LPC
• Aaron Skinner, DC
• Danielle Nicole Skinner, RDN
• William M Skinner
• Nikole L. Skipp

• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.