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Deactivated NPI 1609408152 Deactivated / Inactive NPI Male Practitioner

John Skinner

Counselor • Mesa, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, John Skinner has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 12, 2020
NPI Deactivation Date November 08, 2024
Total Practice Duration ~4 Years of Practice (2020 – 2024)

Professional Overview & Biography Verified Profile Summary

John Skinner was a registered Counselor practicing in Mesa, AZ. Throughout an active medical career spanning 4 years, John Skinner provided care at the practice location at 736 N COUNTRY CLUB DR until profile deactivation on 2024-11-08.

Practice Location & Contact Primary Location

Practice Address

736 N Country Club Dr

Mesa, AZ 852014936

Telephone 4808440011
Fax 4808444084
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Mesa, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.4 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
118 Specialists

Practicing in Mesa, AZ (1205 Statewide)

Telehealth Adoption Rate
1.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License AZ LASAC-15332

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
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NPI Profile Deactivated November 08, 2024

Record deactivated on November 08, 2024

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NPI Profile Deactivated November 07, 2024

Record deactivated on November 07, 2024

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Updated Practice Location March 23, 2023

Registered at 4510 E FOUNTAIN ST, MESA, AZ 852055270 (Tel: 4805214313)

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2023

Counselor (License #LISAC-155247 in AZ)

NPI Profile Active February 14, 2020

NPI status registered as active in NPPES database

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Updated Practice Location February 14, 2020

Registered at 736 N COUNTRY CLUB DR, MESA, AZ 852014936 (Tel: 4808440011)

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Updated Business Mailing Address February 14, 2020

Registered at 4510 E FOUNTAIN ST, MESA, AZ 852055270 (Tel: 4805214313)

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Provider Name / Credentials Updated February 14, 2020

Recorded as JOHN SKINNER

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 14, 2020

Counselor (License #LASAC-15332 in AZ)

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Initial NPI Registration & Enumeration February 12, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1609408152
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 12, 2020
Last Update: February 14, 2020
Deactivation Date: November 08, 2024

Mailing Address

4510 E Fountain St

Mesa, AZ 852055270

Phone: 4805214313

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.