Provider Demographics
NPI:1942446950
Name:HERRERA-LOPEZ, SANDRA (LMFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:HERRERA-LOPEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:HERRERA-LOPEZ, LMFT; LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:CATHOLIC CHARITIES, DIOCESE OF NORWICH, INC.
Mailing Address - Street 2:331 MAIN ST
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-889-8346
Mailing Address - Fax:860-889-2658
Practice Address - Street 1:CATHOLIC CHARITIES, DIOCESE OF NORWICH, INC.
Practice Address - Street 2:331 MAIN ST
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-889-8346
Practice Address - Fax:860-889-2658
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK461584236OtherEMPLOYER IDENTIFICATION NUMBER