Provider Demographics
NPI:1013535665
Name:SKINNER, ABIGAIL ANGELIQUE (MSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ANGELIQUE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 34TH ST RM 602
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3006
Mailing Address - Country:US
Mailing Address - Phone:347-625-5020
Mailing Address - Fax:646-219-6812
Practice Address - Street 1:19 W. 34TH STREET
Practice Address - Street 2:SUITE 602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:347-625-5020
Practice Address - Fax:646-219-6812
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NY111608104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor