Provider Demographics
NPI:1386834380
Name:SKIRVIN, ANN M (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:SKIRVIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3871
Mailing Address - Country:US
Mailing Address - Phone:812-345-3974
Mailing Address - Fax:812-323-8952
Practice Address - Street 1:635 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3871
Practice Address - Country:US
Practice Address - Phone:812-345-3974
Practice Address - Fax:812-323-8952
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INH1279110 39000645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health