Provider Demographics
NPI:1740330687
Name:SKAGGS, EMILY E (PSYD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:E
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 DARBY CREEK RD STE 41
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1671
Mailing Address - Country:US
Mailing Address - Phone:859-227-2337
Mailing Address - Fax:859-268-2472
Practice Address - Street 1:501 DARBY CREEK RD
Practice Address - Street 2:SUITE 7
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1604
Practice Address - Country:US
Practice Address - Phone:859-227-2337
Practice Address - Fax:859-268-2472
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY130317103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100311330Medicaid