Provider Demographics
NPI:1609313899
Name:TRUBEY, PAUL (MSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:TRUBEY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 TAYLOR BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-2426
Mailing Address - Country:US
Mailing Address - Phone:860-208-2887
Mailing Address - Fax:
Practice Address - Street 1:59 TAYLOR BRIDGE RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:CT
Practice Address - Zip Code:06249-2426
Practice Address - Country:US
Practice Address - Phone:860-208-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0039211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical