Provider Demographics
NPI:1235244690
Name:GOLBERT, AIMEE CAROL (MSW)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:CAROL
Last Name:GOLBERT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 PROSPECT AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-4203
Mailing Address - Country:US
Mailing Address - Phone:860-233-4830
Mailing Address - Fax:860-231-6222
Practice Address - Street 1:664 PROSPECT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4203
Practice Address - Country:US
Practice Address - Phone:860-233-4830
Practice Address - Fax:860-231-6222
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0021491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT140002149CT01OtherANTHEM BC & BS
199553OtherMHN
CT133543OtherVALUE OPTIONS
CTHAS787OtherOXFORD HEALTH PLANS