Provider Demographics
NPI:1740603976
Name:SKOLMOWSKI, AMANDA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SKOLMOWSKI
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1946 N 13TH ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7258
Mailing Address - Country:US
Mailing Address - Phone:419-720-9247
Mailing Address - Fax:419-720-0304
Practice Address - Street 1:5115 GLENDALE AVE STE N
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1801
Practice Address - Country:US
Practice Address - Phone:419-476-0784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 1200657101YM0800X
OHS12006571041S0200X
OHI.1700256-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool