Provider Demographics
NPI:1457420473
Name:NIEVES, WILLIAM (MSW,BA,LMSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:NIEVES
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 1:141 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-574-9000
Practice Address - Fax:203-574-9006
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000095104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTNOT ELIGIBLEOtherMHN MANAGED HEALTH NETWORK
CT060669107OtherUBH-CONNECTICARE WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN TRICARENORTH
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669017OtherUNITED BEHAVIORAL HEALTH
CT060669107OtherUBH-LIBERTY/FREEDOM OXFORD HLTH WELLMORE GRP/FACILITY
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT004040705OtherHP MEDICAID
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CTD339210 -WATERBURYOtherVALUE OPTIONS
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT13526788OtherCAQH
CTNOT ELIGIBLEOtherMHN MANAGED HEALTH NETWORK