Healthcare Provider Details

I. General information

NPI: 1487476982
Provider Name (Legal Business Name): DOLLY SKRICKA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 WHEELING RD
ANDOVER CT
06232-1115
US

IV. Provider business mailing address

8 WRIGHT ST STE 107
WESTPORT CT
06880-3114
US

V. Phone/Fax

Practice location:
  • Phone: 860-746-2416
  • Fax: 860-781-9321
Mailing address:
  • Phone: 860-746-2416
  • Fax: 860-781-9321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9055
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16826
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119527
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: