MEDICARE: WILLIAM SKYLER KIRK LCSW

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	104100000X	Social Worker	CSW.09932683	CO

General Provider Information

NPI Number	:	1790462893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SKYLER KIRK LCSW

Provider Business Mailing Address
First Line	:	836 5TH AVE # 249
Second Line	:
City	:	BELLE FOURCHE
State	:	SD
Zip	:	57717-1607
Country	:	US
Telephone Number	:	970-703-3260
Fax Number	:

Provider Business Practice Location Address
First Line	:	836 5TH AVE # 249
Second Line	:
City	:	BELLE FOURCHE
State	:	SD
Zip	:	57717-1607
Country	:	US
Telephone Number	:	970-703-3260
Fax Number	:

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

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	01/12/2026

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