Provider Demographics
NPI:1912440785
Name:SKINNER, SUZANNE MICHELLE (MSW, LISW-CP-S)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MSW, LISW-CP-S
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MICHELLE
Other - Last Name:MAKARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2141
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7141
Mailing Address - Country:US
Mailing Address - Phone:803-319-0910
Mailing Address - Fax:803-403-0337
Practice Address - Street 1:1201 MAIN ST STE 1980
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3299
Practice Address - Country:US
Practice Address - Phone:803-319-0910
Practice Address - Fax:803-403-0337
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical