Healthcare Provider Details

I. General information

NPI: 1174473045
Provider Name (Legal Business Name): MICHELLE AIMEE SKAGEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 E VALLEY RD UNIT 102
BASALT CO
81621-8352
US

IV. Provider business mailing address

78 FERGUSON DR
CARBONDALE CO
81623-9256
US

V. Phone/Fax

Practice location:
  • Phone: 970-927-4666
  • Fax:
Mailing address:
  • Phone: 720-438-1544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09932703
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: