Provider Demographics
NPI:1942863402
Name:SHERRY MICHAUD, LLC
Entity Type:Organization
Organization Name:SHERRY MICHAUD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-798-2776
Mailing Address - Street 1:21 SKINNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:CT
Mailing Address - Zip Code:06232-1110
Mailing Address - Country:US
Mailing Address - Phone:860-798-2776
Mailing Address - Fax:
Practice Address - Street 1:15 HENNEQUIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:CT
Practice Address - Zip Code:06237-1309
Practice Address - Country:US
Practice Address - Phone:860-798-2776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty