Provider Demographics
NPI:1619841582
Name:SKINNER, SOFIA (LMSW)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2028
Mailing Address - Country:US
Mailing Address - Phone:201-870-3038
Mailing Address - Fax:
Practice Address - Street 1:68 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-2028
Practice Address - Country:US
Practice Address - Phone:201-870-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07161100104100000X
NY125000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker