Provider Demographics
NPI:1144754136
Name:SKAFF, JENNIFER KLEVE (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KLEVE
Last Name:SKAFF
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:ONAWA
Mailing Address - State:IA
Mailing Address - Zip Code:51040-1548
Mailing Address - Country:US
Mailing Address - Phone:712-423-9160
Mailing Address - Fax:
Practice Address - Street 1:1600 DIAMOND ST
Practice Address - Street 2:
Practice Address - City:ONAWA
Practice Address - State:IA
Practice Address - Zip Code:51040-1548
Practice Address - Country:US
Practice Address - Phone:712-423-9160
Practice Address - Fax:712-423-9164
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health