Provider Demographics
NPI:1164443404
Name:SKAGGS, AMY CATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CATHERINE
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:LCSW
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 6144
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-6144
Mailing Address - Country:US
Mailing Address - Phone:406-952-4718
Mailing Address - Fax:
Practice Address - Street 1:1601 2ND AVE N STE 631
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3287
Practice Address - Country:US
Practice Address - Phone:406-952-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT680 LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000070955OtherBLUE CROSS/SHIELD OF MONT
MT000050217Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER