Provider Demographics
NPI:1639182579
Name:ALPERT, PAUL BURTON (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:BURTON
Last Name:ALPERT
Suffix:
Gender:M
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 1:2553 WHITNEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3021
Mailing Address - Country:US
Mailing Address - Phone:203-494-9262
Mailing Address - Fax:203-248-3339
Practice Address - Street 1:2553 WHITNEY AVENUE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3021
Practice Address - Country:US
Practice Address - Phone:203-494-9262
Practice Address - Fax:203-248-3339
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0033911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004230314Medicaid
CT800002906Medicare PIN