MEDICARE: PALMER SKUDNESKI MFTC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0014850	CO

General Provider Information

NPI Number	:	1285589374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PALMER SKUDNESKI MFTC

Provider Business Mailing Address
First Line	:	2519 S SHIELDS ST STE 1K
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1855
Country	:	US
Telephone Number	:	720-236-7001
Fax Number	:

Provider Business Practice Location Address
First Line	:	3332 W PROSPECT RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6931
Country	:	US
Telephone Number	:	720-236-7001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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