Provider Demographics
NPI:1619518826
Name:SKEENS, JEFF (LAMFT, MMFT, MDIV)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:
Last Name:SKEENS
Suffix:
Gender:M
Credentials:LAMFT, MMFT, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 N 7TH ST STE 450
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3851
Mailing Address - Country:US
Mailing Address - Phone:602-456-2835
Mailing Address - Fax:
Practice Address - Street 1:4747 N 7TH ST STE 450
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-3851
Practice Address - Country:US
Practice Address - Phone:602-456-2835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-10645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health