Provider Demographics
NPI:1114342029
Name:HANDS, BRENT (LCSW)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:HANDS
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:PO BOX 261140
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06126-1140
Mailing Address - Country:US
Mailing Address - Phone:860-951-7268
Mailing Address - Fax:860-951-7269
Practice Address - Street 1:1477 PARK ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2235
Practice Address - Country:US
Practice Address - Phone:860-951-7268
Practice Address - Fax:860-951-7269
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0083411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical