Provider Demographics
NPI:1487680880
Name:HUSKINS, JOAN G (LCSW,LADC,MSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:G
Last Name:HUSKINS
Suffix:
Gender:F
Credentials:LCSW,LADC,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMIISTRATION
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:WATERBURY OP ADULT SERVICES
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1701
Practice Address - Country:US
Practice Address - Phone:203-755-1143
Practice Address - Fax:203-753-3274
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT59941041C0700X
CT891101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherOPTUM BEHAVIORAL HEALTH/UBH GRP/FACILITY WELLMORE
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT10450310-402 E MAINOtherBEACON HEALTH STRATEGIES, INC.
CT2266879OtherCIGNA BEHAVIORAL HEALTH
CT004039202Medicaid
CTCAC-4700OtherCAC-CERTIFIED ADDICTION COUNSELOR
CT060669107OtherUBH/CONNECTICARE WELLMORE GRP/FACILITY
CT7473885OtherAETNA BEHAVIORAL HEALTH
CTICADC-4700OtherICADC-INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR
11518584OtherCAQH
CT06066917OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT374134OtherMHN TRICARE NORTH
CT060669107OtherUBH-OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CT374134OtherMHN MANAGED HEALTH NETWORK
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CTCCDP-D-4700OtherCCDP-D CERTIFIED CO-OCCURING DISORDERS PROFESSIONAL-DIPLOMATE
CTICCDP-D-4700OtherICCDP-INTERNATIONALLY CERTIFIED CO-OCCURRING DISORDERS PROFESSIONAL
CT7473885OtherAETNA BEHAVIORAL HEALTH