Provider Demographics
NPI:1720174766
Name:SKAGGS, MEREDITH JANE (LCSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:JANE
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 1:17 VISTA PRECIOSO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-3448
Mailing Address - Country:US
Mailing Address - Phone:479-445-3474
Mailing Address - Fax:
Practice Address - Street 1:17 VISTA PRECIOSO
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-3448
Practice Address - Country:US
Practice Address - Phone:479-445-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX586801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical