Provider Demographics
NPI:1033574785
Name:SCHMOOKLER, AKIVA (LCSW)
Entity Type:Individual
Prefix:MR
First Name:AKIVA
Middle Name:
Last Name:SCHMOOKLER
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 1:141 E MAIN ST FL 4
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:402 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1701
Practice Address - Country:US
Practice Address - Phone:203-574-9000
Practice Address - Fax:203-574-9006
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT102181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherHEALTHYCT WELLMORE FACILITY/GRP
CT060669107OtherUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CT13765948OtherCAQH
CTD339123 141 E MAINOtherVALUE OPTIONS
CT060669107OtherUBH-CONNECTICARE WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN-TRICARE NOTH
CT060669107OtherUBH-UNITED HEALTHCARE
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherUBH-OXFORD LIBERTY/FREEDOM WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN NETWORK
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CTD339123 141 E MAINOtherVALUE OPTIONS