Provider Demographics
NPI:1235866872
Name:SKAGGS, CARLI N (LLMSW)
Entity Type:Individual
Prefix:
First Name:CARLI
Middle Name:N
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:CHARLIE
Other - Middle Name:N
Other - Last Name:SKAGGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12354 PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-3061
Mailing Address - Country:US
Mailing Address - Phone:248-468-5708
Mailing Address - Fax:
Practice Address - Street 1:2399 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-1955
Practice Address - Country:US
Practice Address - Phone:248-475-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851115238104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker