Provider Demographics
NPI:1952483265
Name:SKELLY, ROBERT E (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:SKELLY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:PA
Mailing Address - Zip Code:16851-0608
Mailing Address - Country:US
Mailing Address - Phone:717-263-9093
Mailing Address - Fax:717-263-2252
Practice Address - Street 1:43 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2462
Practice Address - Country:US
Practice Address - Phone:717-263-9093
Practice Address - Fax:717-263-2252
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005202L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
156751OtherVALUE OPTIONS
PA50249OtherSOUTH CENTRAL PREFERRED
PASK666502OtherBLUE SHIELD
PA50009675OtherBLUE CROSS
306227OtherMHN
258421OtherMAMSI
156751OtherVALUE OPTIONS