Healthcare Provider Details

I. General information

NPI: 1578552626
Provider Name (Legal Business Name): HEATH HENRY HIGHTOWER MSW, LCSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 MAPLE AVE
WINDSOR CT
06095-2922
US

IV. Provider business mailing address

32 MAPLE AVE
WINDSOR CT
06095-2922
US

V. Phone/Fax

Practice location:
  • Phone: 860-298-9189
  • Fax: 860-688-0004
Mailing address:
  • Phone: 860-298-9189
  • Fax: 860-688-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number005437
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110572
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier468360
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerVALUE OPTIONS
# 2
Identifier290601/252147
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerMHN
# 3
Identifier218938
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerCOMPSYCH CORPS.
# 4
Identifier140005437CT01
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerANTHEM BC/BS
# 5
IdentifierANC 1198
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerOXFORD HEALTH INS.

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: