Provider Demographics
NPI:1740776756
Name:SALLIE SPIGNESI LMFT LLC
Entity Type:Organization
Organization Name:SALLIE SPIGNESI LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIGNESI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-494-0653
Mailing Address - Street 1:1 S MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3872
Mailing Address - Country:US
Mailing Address - Phone:203-494-0653
Mailing Address - Fax:
Practice Address - Street 1:1 S MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3872
Practice Address - Country:US
Practice Address - Phone:203-494-0653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1299106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008048473Medicaid