Provider Demographics
NPI:1366414237
Name:HURLEY, ROBERT JOSEPH (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:HURLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 ROLLING WOOD DR
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4926
Mailing Address - Country:US
Mailing Address - Phone:203-371-1055
Mailing Address - Fax:
Practice Address - Street 1:2505 MAIN ST
Practice Address - Street 2:STE 208
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-5813
Practice Address - Country:US
Practice Address - Phone:203-386-1977
Practice Address - Fax:203-386-1977
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT140001084CT02OtherANTHEM BCBS
CT079596OtherMANAGED HEALTH NETWORK
CT163613OtherVALUE OPTIONS
CTP2537419OtherOXFORD HEALTH PLANS
CT0005556121OtherAETNA
CT079596OtherMANAGED HEALTH NETWORK