Provider Demographics
NPI:1679508840
Name:SKIBA, DAVID E (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:SKIBA
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 BEECHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-1466
Mailing Address - Country:US
Mailing Address - Phone:716-297-3067
Mailing Address - Fax:
Practice Address - Street 1:884 BRIGHTON RD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8169
Practice Address - Country:US
Practice Address - Phone:716-836-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039117-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical