Provider Demographics
NPI:1821132200
Name:OSADCHEY, SHERRY L (MA, LMFT, SEP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:OSADCHEY
Suffix:
Gender:F
Credentials:MA, LMFT, SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2362
Mailing Address - Country:US
Mailing Address - Phone:860-677-5300
Mailing Address - Fax:860-255-7600
Practice Address - Street 1:780 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2362
Practice Address - Country:US
Practice Address - Phone:860-677-5300
Practice Address - Fax:860-255-7600
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT565106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410000565CT02OtherANTHEM BCBS