Provider Demographics
NPI:1992845325
Name:TRAFFORD, ROBERT JOHNSTON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOHNSTON
Last Name:TRAFFORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:158 SELDEN HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3129
Mailing Address - Country:US
Mailing Address - Phone:860-523-0288
Mailing Address - Fax:860-652-3431
Practice Address - Street 1:36 WELLES ST STE 230
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2080
Practice Address - Country:US
Practice Address - Phone:869-523-0288
Practice Address - Fax:860-652-3431
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0011931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT205426OtherCOMPSYCH
CT0005432528OtherAETNA BEHAVIORAL HEALTH
CT42692OtherCIGNA
CT208736000OtherMAGELLAN
CT140001193CT18OtherANTHEM
CTP1249702OtherOXFORD
CT62-71812OtherUNITED BEHAVIORAL HEALTH
CT133092OtherVALUE OPTIONS
CT140001193CT19OtherANTHEM
CT140001193CT18OtherANTHEM
CTR39344Medicare UPIN