Provider Demographics
NPI:1164094017
Name:SARAH OUELLETTE PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:SARAH OUELLETTE PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:OUELLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-368-7809
Mailing Address - Street 1:324 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-1251
Mailing Address - Country:US
Mailing Address - Phone:401-368-7809
Mailing Address - Fax:
Practice Address - Street 1:173 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3919
Practice Address - Country:US
Practice Address - Phone:401-400-2499
Practice Address - Fax:401-642-7308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health