Provider Demographics
NPI:1497829071
Name:SKYRMS, DEBRA KAY (NCC LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:KAY
Last Name:SKYRMS
Suffix:
Gender:F
Credentials:NCC LPC
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:KAY
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:E2391 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981-9199
Mailing Address - Country:US
Mailing Address - Phone:715-258-2529
Mailing Address - Fax:715-258-2529
Practice Address - Street 1:902 RIVERSIDE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-1992
Practice Address - Country:US
Practice Address - Phone:715-256-1475
Practice Address - Fax:715-256-0705
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2903125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40979700Medicaid