1. Home
  2. Directory
  3. Washington
  4. Kelso
  5. Counselor
  6. NPI Profile

MR. SHANE ANDREW SKINNER SR. CDP
NPI 1962979724
Counselor - Addiction (Substance Use Disorder) in Kelso, WA

Active since October 30, 2018
404 W MAIN ST, KELSO, WA 98626(360) 423-2806(360) 423-2806 Get Directions Write a Review

NPPES record last updated: October 30, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Shane Andrew Skinner Sr. Cdp NPPES

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

MR. SHANE ANDREW SKINNER SR. CDP (NPI 1962979724) is an individual addiction (substance use disorder) provider in Kelso, Washington, licensed in Washington (CP60688887) and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1962979724
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. SHANE ANDREW SKINNER SR.Credential: CDP
Location Address404 W MAIN STKelso, WA 98626-1118
Mailing Address404 W Main StKelso, WA 98626-1118 · (360) 423-2806 · Fax (360) 423-2806
Phone(360) 423-2806
Fax(360) 423-2806
Sole ProprietorNo
Enumeration DateOctober 30, 2018
✔ NPI 1962979724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · CP60688887
404 W MAIN ST, Kelso, WA 98626
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELODY KAY LORENZO
Psychologist (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
APRIL MARIE BASZLER
Counselor (Mental Health)
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
BRITTANY LYNN BIRTCHET CDPT
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
STACY RAEANN WIRKKALA SUDPT
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
AWAKENINGS, INC
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
CORTNEY ANN BAKER CPC
Peer Specialist
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
MEGHAN DEGALLIER MSW, MHP, LICSWA
Counselor (Mental Health)
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
BREANNA SLAPE-LORENZO
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806

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 Shane Skinner's NPI number?

The NPI number for Shane Skinner is 1962979724. It was assigned to this individual provider in the NPPES registry on October 30, 2018.

Where is Shane Skinner located?

Shane Skinner practices at 404 W Main St, Kelso, WA 98626. The listed phone number is (360) 423-2806.

What is Shane Skinner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Shane Skinner was last updated on October 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.