Provider Demographics
NPI:1881095602
Name:SKAVHAUG, JENNIFER SUSAN (MA, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUSAN
Last Name:SKAVHAUG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 BRITTANY ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3998
Mailing Address - Country:US
Mailing Address - Phone:907-444-6693
Mailing Address - Fax:417-374-0271
Practice Address - Street 1:6800 BRITTANY ROCK WAY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3998
Practice Address - Country:US
Practice Address - Phone:907-444-6693
Practice Address - Fax:417-374-0271
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017009310101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor