Provider Demographics
NPI:1346565207
Name:SKAGGS, ANDREW GREGORY (LPCC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:GREGORY
Last Name:SKAGGS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:948 ELM ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2277
Mailing Address - Country:US
Mailing Address - Phone:270-266-1188
Mailing Address - Fax:270-908-2880
Practice Address - Street 1:948 ELM ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2277
Practice Address - Country:US
Practice Address - Phone:270-266-1188
Practice Address - Fax:270-908-2880
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY163465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional