Benjamin Mark Skaggs, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW-34723 Issued in ID

Practice address

9196 W Barnes Dr Ste 45
Boise, ID 83709-1552

Phone

(208) 433-0400

NPI assigned

Jun 8, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1972823391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 N CHITWOOD WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837046009",
            "telephone_number": "208-989-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9196 W BARNES DR STE 45",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091552",
            "telephone_number": "208-433-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAGGS",
        "first_name": "BENJAMIN",
        "middle_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-34723",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "ID",
            "license": "LCSW-34723",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LCSW-34723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Sisterman, DNP
• Thompson Siverson, LCPC
• Taylor Sjobakken, PHARMD
• Christopher Jay Sjoberg, NP
• Rachel Sjoberg
• Kevin Skaggs, REGISTERED NURSE RN
• Sophia Skarvan
• Kristi Skeem, LPC, ACADC, NCC
• Katherine Skelly, P.A.
• Kaycee Skelton

• Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.