MEDICARE: WILLIAM NIEVES MSW,BA,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	000095	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NOT ELIGIBLE	OTHER	CT	MHN MANAGED HEALTH NETWORK
2	060669107	OTHER	CT	UBH-CONNECTICARE WELLMORE GRP/FACILITY
3	NOT ELIGIBLE	OTHER	CT	MHN TRICARENORTH
4	PENDING	OTHER	CT	CIGNA BEHAVIORAL HEALTH
5	060669017	OTHER	CT	UNITED BEHAVIORAL HEALTH
6	060669107	OTHER	CT	UBH-LIBERTY/FREEDOM OXFORD HLTH WELLMORE GRP/FACILITY
7	060669107	OTHER	CT	ANTHEM BCBS OF CT WELLMORE GRP/FACILITY
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	060669107	OTHER	CT	HEALTHYCT WELLMORE GRP/FACILITY
10	D339210 -WATERBURY	OTHER	CT	VALUE OPTIONS
11	PENDING	OTHER	CT	AETNA BEHAVIORAL HEALTH
12	060669107	OTHER	CT	UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
13	13526788	OTHER	CT	CAQH

General Provider Information

NPI Number	:	1457420473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM NIEVES MSW,BA,LMSW

Provider Business Mailing Address
First Line	:	141 E MAIN ST
Second Line	:	4TH FLOOR ADMINISTRATION
City	:	WATERBURY
State	:	CT
Zip	:	06702-2310
Country	:	US
Telephone Number	:	203-574-9000
Fax Number	:	203-574-9006

Provider Business Practice Location Address
First Line	:	141 E MAIN ST
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06702-2310
Country	:	US
Telephone Number	:	203-574-9000
Fax Number	:	203-574-9006

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	06/04/2021

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