Provider Demographics
NPI:1699166934
Name:DRAPER, HALLIE C (LCSW)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:C
Last Name:DRAPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HALLIE
Other - Middle Name:C
Other - Last Name:HEINEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-2170
Mailing Address - Country:US
Mailing Address - Phone:860-271-4715
Mailing Address - Fax:
Practice Address - Street 1:1 WAHOO AVE
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06349-2324
Practice Address - Country:US
Practice Address - Phone:860-694-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT89221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical