Provider Demographics
NPI:1124120357
Name:HAUCK, CLAUDETTE B (LCSW)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:B
Last Name:HAUCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-3233
Mailing Address - Country:US
Mailing Address - Phone:203-268-9957
Mailing Address - Fax:
Practice Address - Street 1:149 DURHAM RD
Practice Address - Street 2:SUITE 31
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2677
Practice Address - Country:US
Practice Address - Phone:203-245-1956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0047851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2172638OtherCIGNA
CT285942OtherMANAGED HEALTH NETWORK
CT528411OtherVALUE OPTIONS
CT140004785CT02OtherANTHEM
CT6296191OtherUNITED BEHAVIORAL HEALTH
CTA3463246OtherOXFORD