Provider Demographics
NPI:1356358634
Name:SKALSKY, ROBIN MICHAEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:MICHAEL
Last Name:SKALSKY
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MR
Other - First Name:ROBIN
Other - Middle Name:MICHAEL
Other - Last Name:SKALSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1716 SUTTERVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822
Mailing Address - Country:US
Mailing Address - Phone:916-397-1565
Mailing Address - Fax:
Practice Address - Street 1:2130 STOCKTON BLVD SUITE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-456-5485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21202101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker