Julie Gagnon Skillicorn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8760 Issued in MT

Practice address

1836 South Ave W
Missoula, MT 59801-6510

Phone

(406) 396-0197

NPI assigned

Nov 5, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1093111973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CASCADE ST",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "598479613",
            "telephone_number": "406-396-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016510",
            "telephone_number": "406-396-0197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2112 DIXON AVE",
            "address_purpose": "LOCATION",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018226",
            "country_code": "US",
            "telephone_number": "406-396-0197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON SKILLICORN",
        "first_name": "JULIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "8760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.