Healthcare Provider Details

I. General information

NPI: 1679273742
Provider Name (Legal Business Name): NORA ELIZABETH HAWLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SIMSBURY RD
AVON CT
06001-3763
US

IV. Provider business mailing address

290 BRITTANY FARMS RD APT H
NEW BRITAIN CT
06053-1146
US

V. Phone/Fax

Practice location:
  • Phone: 203-885-6561
  • Fax:
Mailing address:
  • Phone: 203-885-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number012189
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: