Provider Demographics
NPI:1851662829
Name:HASWELL, ROBERT A (MSW,BA,LMSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:HASWELL
Suffix:
Gender:M
Credentials:MSW,BA,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
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 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:2012-01-23
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3047104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherANTHEM BCBC OF CT FACILITY/GRP WELLMORE
CT060669107OtherUBH-OXFORD LIBERTY/FREEDOM GRP/FACILITY-WELLMORE
CT13817567OtherCAQH
CTD339123-141 E MAINOtherVALUE OPTIONS
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherUBH-CONNECTICARE GRP/FACILITY WELLMORE
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT008064297Medicaid
CT060669107OtherHEALTHYCT GRP/FACILITY-WELLMORE
CT060669106OtherUNITED BEHAVIORAL HEALTH GRP/FACILITY-WELLMORE
CTNOT ELIGIBLEOtherMHN MANAGE HEALTH NETWORK
CTNOT ELIGIBLEOtherMHN TRICARENORTH
CT060669107OtherUBH-UNITED HEALTHCARE GRP/FACILITY WELLMORE
CTNOT ELIGIBLEOtherMHN TRICARENORTH