MEDICARE: SOFIA SKINNER LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SL07161100	NJ
2	104100000X	Social Worker	125000	NY

General Provider Information

NPI Number	:	1619841582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFIA SKINNER LMSW

Provider Business Mailing Address
First Line	:	68 HAMILTON AVE
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628-2028
Country	:	US
Telephone Number	:	201-870-3038
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 HAMILTON AVE
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628-2028
Country	:	US
Telephone Number	:	201-870-3038
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/24/2025

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Directions to “ SOFIA SKINNER LMSW” Practice Location

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