1497932644 NPI number — MRS. COLLEEN MURPHY HILLIARD L.M.F.T.

Table of content: MRS. COLLEEN MURPHY HILLIARD L.M.F.T. (NPI 1497932644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497932644 NPI number — MRS. COLLEEN MURPHY HILLIARD L.M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILLIARD
Provider First Name:
COLLEEN
Provider Middle Name:
MURPHY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.M.F.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497932644
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 702
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIMSBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06070-0702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-305-8491
Provider Business Mailing Address Fax Number:
860-231-7809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
776 FARMINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06119-1677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-326-0287
Provider Business Practice Location Address Fax Number:
860-231-7809
Provider Enumeration Date:
01/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  000936 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50ANCOINCCT01 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P3644323 . This is a "OXFORD HEALTH, INC" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 62-28975 . This is a "UNITED BEHAVORIAL HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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