Skidmore, Jonathan

Skidmore, Jonathan is an individual health care provider with primary practice located at 6715 Dorr St. , Toledo OH 43615. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Skidmore, Jonathan can be contacted via phone (419) 868-1178.

Contact Information

Primary practice address
6715 Dorr St. Toledo OH 43615
Phone: (419) 868-1178
Fax: (419) 868-1989
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.1502371 Ohio

Profile Details

NPI number 1801260963
LBN Legal business name Skidmore, Jonathan
Credentials MSW, LISW-S, CTP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2015
Last updated Sep 3rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801260963 NPPES
Ohio MEDICAID 0165312

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