Healthcare Provider Details

I. General information

NPI: 1184758393
Provider Name (Legal Business Name): KARI LYNN SKORDAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 DALEY ST
RAWLINS WY
82301-5911
US

IV. Provider business mailing address

PO BOX 911
RAWLINS WY
82301-0911
US

V. Phone/Fax

Practice location:
  • Phone: 307-324-5899
  • Fax:
Mailing address:
  • Phone: 307-324-5899
  • Fax: 307-324-2695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-761
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: