Terrance Joseph Skidmore, LCSW
Social Worker, Clinical in Gulfport, MS. Individual provider (NPI-1).
NPI number1851697635
StatusActive
Last updated in NPPESSep 18, 2020
Details
- NPI
- 1851697635
- Entity type
- Individual (NPI-1)
- Name
- Mr. Terrance Joseph Skidmore
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 27, 2011
- Certification date
- Sep 18, 2020
- Last updated
- Sep 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C8764 | MS | Yes |
| 1041C0700X | Social Worker, Clinical | 8842 | LA |
Practice location
1600 Broad AveGulfport, MS 39501-3603
Phone 228-865-1330
Mailing address
37161 Audubon Park AveGeismar, LA 70734-3265
Phone 337-853-2292 · Fax 225-313-3563
Other practice locations
37161 Audubon Ave.
Geismar, LA 70734
Geismar, LA 70734
Phone 337-853-2292 · Fax 225-313-3563
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