Individual
MR. AKIVA SCHMOOKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
402 E MAIN ST, WATERBURY, CT 06702-1701
(203) 574-9000
(203) 574-9006
Mailing address
141 E MAIN ST FL 4, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10218
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060669107
ANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT
01
—
13765948
CAQH
CT
01
—
D339123 141 E MAIN
VALUE OPTIONS
CT
01
—
NOT ELIGIBLE
MHN-TRICARE NOTH
CT
01
—
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
12/23/2015
Last updated
09/25/2019
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