Provider Demographics
NPI:1225096084
Name:HUGHES, RONALD MINER (LCSW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:MINER
Last Name:HUGHES
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 545
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-0545
Mailing Address - Country:US
Mailing Address - Phone:860-360-1111
Mailing Address - Fax:
Practice Address - Street 1:20 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382
Practice Address - Country:US
Practice Address - Phone:860-848-3098
Practice Address - Fax:860-848-1152
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0008691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800003205Medicare ID - Type Unspecified