Individual provider Active NPI

Sara Elizabeth Skonieczny, LICSW

  • Clinical Social Worker
  • Wellesley, MA
National Provider Identifier
1407164908
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118093 Issued in MA
Practice address
25 Walnut St Ste 300
Wellesley, MA 02481-2145
Phone
(617) 286-5002
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 118093 MA Primary

Addresses

Primary practice location

25 Walnut St Ste 300
Wellesley, MA 02481-2145

Mailing address

25 Walnut St Ste 300
Wellesley Hills, MA 02481-2145
Phone (508) 331-0577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 10, 2024 through Apr 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
118093MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1407164908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WALNUT ST STE 300",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024812145",
            "telephone_number": "508-331-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WALNUT ST STE 300",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024812145",
            "telephone_number": "617-286-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKONIECZNY",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.