Individual provider Active NPI

Joseph C Skolnik, LICSW

  • Clinical Social Worker
  • Lexington, MA
National Provider Identifier
1356362636
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103405 Issued in MA
Practice address
9 Meriam St
Ste 18
Lexington, MA 02420-5300
Phone
(781) 863-1966
NPI assigned
Jul 21, 2006
Last updated
Nov 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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 103405 MA Primary

Addresses

Primary practice location

9 Meriam St
Ste 18
Lexington, MA 02420-5300

Mailing address

108 Bray St
Gloucester, MA 01930-1554
Phone (978) 281-8445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060210000099 MA Practitioner - Clinical Social Worker 0244264059 Practice locations: Gloucester, MA; Lexington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

108 Bray St
Gloucester, MA 01930-1554
Phone (978) 281-8445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103405MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1356362636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BRAY ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301554",
            "telephone_number": "978-281-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MERIAM ST",
            "address_2": "STE 18",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024205300",
            "telephone_number": "781-863-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOLNIK",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.