Provider Demographics
NPI:1346312667
Name:SKOY, PHYLLIS M (LISW)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:M
Last Name:SKOY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 GEORGIA ST NE
Mailing Address - Street 2:BLDG. A SUITE 4
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1359
Mailing Address - Country:US
Mailing Address - Phone:505-480-8225
Mailing Address - Fax:
Practice Address - Street 1:3901 GEORGIA ST NE
Practice Address - Street 2:BLDG. A SUITE 4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1359
Practice Address - Country:US
Practice Address - Phone:505-480-8225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-045701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical