Provider Demographics
NPI:1093841256
Name:SHERRI RAININGBIRD LLC
Entity Type:Organization
Organization Name:SHERRI RAININGBIRD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAININGBIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-206-0544
Mailing Address - Street 1:1449 OLD WATERBURY RD
Mailing Address - Street 2:ONE RESERVOIR OFFICE PARK 306B
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488
Mailing Address - Country:US
Mailing Address - Phone:203-206-0544
Mailing Address - Fax:203-283-7407
Practice Address - Street 1:1449 OLD WATERBURY RD
Practice Address - Street 2:ONE RESERVOIR OFFICE PARK 306B
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488
Practice Address - Country:US
Practice Address - Phone:203-206-0544
Practice Address - Fax:203-283-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000716106H00000X
CTCT000716106H00000X
NMNM0066162106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty