Individual provider Active NPI

Henrietta Skornick, LCSW

  • Clinical Social Worker
  • Asbury Park, NJ
National Provider Identifier
1174732481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00438400 Issued in NJ
Practice address
705 Summerfield Ave
Asbury Park, NJ 07712-6921
Phone
(732) 774-6886
Fax
(732) 774-8809
NPI assigned
May 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00438400 NJ Primary

Addresses

Primary practice location

705 Summerfield Ave
Asbury Park, NJ 07712-6921

Mailing address

705 Summerfield Ave
Asbury Park, NJ 07712-6921
Phone (732) 774-6886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00438400NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174732481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 SUMMERFIELD AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077126921",
            "telephone_number": "732-774-6886",
            "fax_number": "732-774-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SUMMERFIELD AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077126921",
            "telephone_number": "732-774-6886",
            "fax_number": "732-774-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKORNICK",
        "first_name": "HENRIETTA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00438400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asbury Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.