Organization Active NPI

Rudolph Skowronski LCSW LLC

  • Clinical Social Worker
  • Saco, ME
National Provider Identifier
1265506604
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC6729 Issued in ME
Legal business name
RUDOLPH SKOWRONSKI LCSW LLC
Practice address
199 Main St FL 3
Saco, ME 04072-1508
Phone
(207) 776-8245
Fax
(207) 571-3263
NPI assigned
Nov 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mr. Rudolph Albert Skowronski, LCSWNPI 1386680858
Title
Psychotherapist
Phone
(207) 571-3008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LC6729 ME Primary

Addresses

Primary practice location

199 Main St FL 3
Saco, ME 04072-1508

Mailing address

276 Back Rd
Alfred, ME 04002-3289
Phone (207) 776-8245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081016000050 ME Part B Supplier - Clinic/Group Practice 6507924784 Receives reassigned benefits from 1 practitioner
Practice locations: Saco, ME

National Provider Directory

National Provider Directory

Locations

199 Main St
Fl 3
Saco, ME 04072
Phone (207) 571-3008

110 Main St
Ste 1306
Saco, ME 04072
Phone (207) 571-3008

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1265506604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 BACK RD",
            "city": "ALFRED",
            "state": "ME",
            "postal_code": "040023289",
            "telephone_number": "207-776-8245",
            "fax_number": "207-571-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 MAIN ST FL 3",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721508",
            "telephone_number": "207-776-8245",
            "fax_number": "207-571-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDOLPH SKOWRONSKI LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "SKOWRONSKI",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "207-571-3008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.