Provider Demographics
NPI:1982022463
Name:SKEENS, CAITLIN VIRGINIA (LPC, PMH-C)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:VIRGINIA
Last Name:SKEENS
Suffix:
Gender:F
Credentials:LPC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25932 N SANDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-6837
Mailing Address - Country:US
Mailing Address - Phone:602-620-7952
Mailing Address - Fax:480-323-2037
Practice Address - Street 1:25932 N SANDSTONE WAY
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-6837
Practice Address - Country:US
Practice Address - Phone:602-620-7952
Practice Address - Fax:480-323-2037
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60446973101YA0400X
WACG60452759101YM0800X
AZ05.15.2021374J00000X
AZLAC-18776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No374J00000XNursing Service Related ProvidersDoula