Provider Demographics
NPI:1184351421
Name:SKIBA, MEGHAN (MS, LPC, CRC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SKIBA
Suffix:
Gender:F
Credentials:MS, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 ALLEGRETTO CIR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2541
Mailing Address - Country:US
Mailing Address - Phone:334-561-2884
Mailing Address - Fax:
Practice Address - Street 1:1690 STONE VILLAGE LN NW STE 101
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7778
Practice Address - Country:US
Practice Address - Phone:404-369-0916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
596803225C00000X
GALPC015432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor