Provider Demographics
NPI:1700522810
Name:SKIEF, SERENA
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:SKIEF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 HUNTERS RIDGE DR APT 1
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-1109
Mailing Address - Country:US
Mailing Address - Phone:517-899-5062
Mailing Address - Fax:
Practice Address - Street 1:913 W HOLMES RD STE 200
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-0411
Practice Address - Country:US
Practice Address - Phone:517-887-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)