Provider Demographics
NPI:1306805155
Name:HRYB, DONNA (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:HRYB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:BARBARA
Other - Last Name:DUBEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:1031 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032
Mailing Address - Country:US
Mailing Address - Phone:860-677-2550
Mailing Address - Fax:860-677-4975
Practice Address - Street 1:1031 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032
Practice Address - Country:US
Practice Address - Phone:860-677-2550
Practice Address - Fax:860-677-4975
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0019981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
211852OtherMANAGED HEALTH
CT140001998CT03OtherANTHEM BC
P1062860OtherOXFORD