Provider Demographics
NPI:1366593865
Name:STERN, HILLARY (LCSW)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-0413
Mailing Address - Country:US
Mailing Address - Phone:860-208-8519
Mailing Address - Fax:860-423-3566
Practice Address - Street 1:134 A CONANTVILLE ROAD
Practice Address - Street 2:
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250
Practice Address - Country:US
Practice Address - Phone:860-208-8519
Practice Address - Fax:860-429-2227
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0060321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT7306143OtherAETNA
140006032CT01OtherANTHEM CENTURY - PPO PRODUCTS
CT004267416Medicaid
CT140006032CT01OtherANTHEM BLUE CARE
CT395038OtherHEALTHNET MHN
CT004267416Medicaid