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NICOLE R SKODACK CTRS
NPI 1235684986
Recreation Therapist in Grand Haven, MI

Active since August 23, 2016
1719 WISCONSIN AVE, GRAND HAVEN, MI 49417(616) 540-4911 Get Directions Write a Review

NPPES record last updated: August 23, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicole R Skodack Ctrs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE R SKODACK CTRS (NPI 1235684986) is an individual recreation therapist in Grand Haven, Michigan and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1235684986
Entity TypeIndividualFemale
Primary Taxonomy225800000X
Provider Legal NameNICOLE R SKODACKCredential: CTRS
Location Address1719 WISCONSIN AVEGrand Haven, MI 49417-2576
Mailing Address1719 Wisconsin AveGrand Haven, MI 49417-2576 · (616) 540-4911
Phone(616) 540-4911
Sole ProprietorNo
Enumeration DateAugust 23, 2016
✔ NPI 1235684986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRecreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225800000X
Definition
A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient.
1719 WISCONSIN AVE, Grand Haven, MI 49417
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Skodack's NPI number?

The NPI number for Nicole Skodack is 1235684986. It was assigned to this individual provider in the NPPES registry on August 23, 2016.

Where is Nicole Skodack located?

Nicole Skodack practices at 1719 Wisconsin Ave, Grand Haven, MI 49417. The listed phone number is (616) 540-4911.

What is Nicole Skodack's specialty?

The primary specialty registered for this NPI is Recreation Therapist with taxonomy code 225800000X.

When was this NPI record last updated?

The NPPES record for Nicole Skodack was last updated on August 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.