Provider Demographics
NPI:1356475099
Name:SKRINCOSKY, JEAN M (LCSW)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:SKRINCOSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10573 ORCHARD BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-4694
Mailing Address - Country:US
Mailing Address - Phone:804-402-8864
Mailing Address - Fax:
Practice Address - Street 1:2301 N PARHAM RD STE 5
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-3171
Practice Address - Country:US
Practice Address - Phone:804-270-1124
Practice Address - Fax:804-270-2090
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040026551041C0700X
PACW0149551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108994K34Medicare PIN