Healthcare Provider Details

I. General information

NPI: 1225096084
Provider Name (Legal Business Name): RONALD MINER HUGHES LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MAPLE AVE
MONTVILLE CT
06382
US

IV. Provider business mailing address

PO BOX 545
HEBRON CT
06248-0545
US

V. Phone/Fax

Practice location:
  • Phone: 860-848-3098
  • Fax: 860-848-1152
Mailing address:
  • Phone: 860-360-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number000869
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: