Provider Demographics
NPI:1649420423
Name:SKULICZ, KRISTEN ANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:ANNE
Last Name:SKULICZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 BILTMORE AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4504
Mailing Address - Country:US
Mailing Address - Phone:828-254-2700
Mailing Address - Fax:828-254-1524
Practice Address - Street 1:356 BILTMORE AVE
Practice Address - Street 2:STE. 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4504
Practice Address - Country:US
Practice Address - Phone:828-254-2700
Practice Address - Fax:828-254-1524
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NCC0098961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker