Provider Demographics
NPI:1700372257
Name:SKIRO, CAROLYNN MAUREEN (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYNN
Middle Name:MAUREEN
Last Name:SKIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAROLYNN
Other - Middle Name:MAUREEN
Other - Last Name:LITTLEFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7410 NORTHSIDE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-4277
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7410 NORTHSIDE DR STE 201
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-4277
Practice Address - Country:US
Practice Address - Phone:843-569-3079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11773104100000X
NCC0128741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker