Healthcare Provider Details

I. General information

NPI: 1891199626
Provider Name (Legal Business Name): AMELIA SKOLNICK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W 26TH ST # 406
NEW YORK NY
10010-1004
US

IV. Provider business mailing address

25 W 26TH ST # 406
NEW YORK NY
10010-1004
US

V. Phone/Fax

Practice location:
  • Phone: 914-588-0028
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number086126-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: