Provider Demographics
NPI:1639665623
Name:SKALSKY, KIRSTEN RUTH (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:RUTH
Last Name:SKALSKY
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55876 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:PARKERS PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56361-5019
Mailing Address - Country:US
Mailing Address - Phone:320-760-4220
Mailing Address - Fax:
Practice Address - Street 1:240 SHADY LANE DR
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-3093
Practice Address - Country:US
Practice Address - Phone:218-319-6016
Practice Address - Fax:218-632-6583
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health