MR. KEVIN SKIDMORE (NPI# 1275921033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275921033 |
| Entity Type | Individual |
| Full Name | MR. KEVIN SKIDMORE |
| Credential | LMSW |
| Practice Address |
43211 Dalcoma Dr Suite 7 Clinton Township MI 48038-6309 |
| Practice Telephone | 5864214513 |
| Practice Fax Number | 5869488416 |
| Mailing Telephone | 5864214513 |
| Mailing Fax Number | 5869488416 |
| Enumeration Date | 2015-01-02 |
| Last Update Date | 2015-01-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801077644 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE OF MICHIGAN LMSW LICENSE | 6801077644 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093060188 | Kevin Allen Skidmore | Optometrist | 854 Ridgewood Drive, Berea, KY 40403 | 2012-07-16 |
| Street Address |
43211 DALCOMA DR SUITE 7 |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip Code | 48038-6309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793360 | Gunateet K Goswami | Internal Medicine | 43211 Dalcoma Dr, Suite 9, Clinton Township, MI 48038-6309 | 2005-07-08 |
| 1043609407 | Top Cardiology Associates of Michigan Pllc | Internal Medicine | 43211 Dalcoma Dr, Suite 9, Clinton Township, MI 48038-6309 | 2015-01-22 |
| 1205011319 | Gynecology and Holistic Care PC | Obstetrics & Gynecology | 43211 Dalcoma Dr, Suite 4, Clinton Township, MI 48038-6309 | 2008-01-08 |
| 1093899569 | Baddigam Family Psychiatric Associates Pllc | Clinical Nurse Specialist | 43211 Dalcoma Dr, Ste. 3, Clinton Township, MI 48038-6309 | 2006-10-24 |
| 1528085263 | Shishir Senapati | General Practice | 43211 Dalcoma Dr, #3, Clinton Township, MI 48038-6309 | 2006-07-17 |
| 1134145766 | Jamshid Bhavnagri | Obstetrics & Gynecology | 43211 Dalcoma Dr, Suite 4, Clinton Township, MI 48038-6309 | 2006-07-15 |
| 1063449502 | Amit K Garg M.d., P.C. | Internal Medicine | 43211 Dalcoma Dr, Suite 9, Clinton Township, MI 48038-6309 | 2006-06-28 |
| 1871560326 | Martin Gerard Wunsch | Clinical Neuropsychologist | 43211 Dalcoma Dr, Suite 11, Clinton Township, MI 48038-6309 | 2006-03-03 |
| 1932181559 | Amit Kumar Garg | Internal Medicine | 43211 Dalcoma Dr, Suite 9, Clinton Township, MI 48038-6309 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780296939 | Phillip Maurice Sherman | Social Worker | 17790 Maisons Dr, Clinton Township, MI 48038-3801 | 2020-08-19 |
| 1639796972 | Heidi Dawn Connors-boccomino | Social Worker | 37400 Garfield Rd Ste 130, Clinton Township, MI 48036-3648 | 2020-07-02 |
| 1295243087 | Anthony F Woznicki | Social Worker | 16931 19 Mile Rd Ste 140, Clinton Township, MI 48038-4841 | 2018-01-16 |
| 1619492071 | Anna Elizabeth Baur | Social Worker | 44899 Centre Ct Ste 101, Clinton Township, MI 48038-5510 | 2017-08-07 |
| 1093240525 | Laura Duncan | Social Worker | 22600 Hall Rd, Ste 201, Clinton Township, MI 48036-1171 | 2017-04-21 |
| 1144672593 | Renee Edgar | Social Worker | 16931 19 Mile Rd, Clinton Township, MI 48038-4841 | 2016-07-11 |
| 1346645413 | Jennifer Renae Kljajic | Social Worker | 24412 Alpine St, Clinton Township, MI 48036-2804 | 2014-10-30 |
| 1407262066 | Natalie M Kostanecki | Social Worker | 21885 Dunham Road Suite 1, Clinton Township, MI 48036-1610 | 2014-07-03 |
| 1467862532 | Dorothy Pilla | Social Worker | 17181 Knollwood Ct, Clinton Township, MI 48038-2831 | 2014-04-29 |
| 1255754735 | Sarah Eisenberg | Social Worker | 43211 Dalcoma Dr Ste 7, Clinton Township, MI 48038-6309 | 2014-02-04 |
| Find all providers in CLINTON TOWNSHIP | ||||
| City | CLINTON TOWNSHIP |
| Zip Code | 48038 |
Please comment or provide details below to improve the information on MR. KEVIN SKIDMORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.