Provider Demographics
NPI:1477604825
Name:BROWN, HILARY BALDWIN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:HILARY
Middle Name:BALDWIN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MAIN ST
Mailing Address - Street 2:INTEGRATIVE PSYCHOTHERAPY
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3133
Mailing Address - Country:US
Mailing Address - Phone:860-657-9891
Mailing Address - Fax:
Practice Address - Street 1:1625 MAIN ST
Practice Address - Street 2:INTEGRATIVE PSYCHOTHERAPY
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-3133
Practice Address - Country:US
Practice Address - Phone:860-657-9891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00015561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0001556OtherCONNECTICUT LICENSE NUMBE
CT02 SBA TI3237OtherBUS.OWNER'SINS.POL.#
CTSWL-4716963OtherPROF.INS.LIABILITY #
CT02 SBA TI3237OtherBUS.OWNER'SINS.POL.#