Provider Demographics
NPI:1063954410
Name:SARAH PIRES, PSYD, LLC
Entity type:Organization
Organization Name:SARAH PIRES, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:203-915-7304
Mailing Address - Street 1:451 STATE ST STE B2
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3070
Mailing Address - Country:US
Mailing Address - Phone:203-915-7304
Mailing Address - Fax:
Practice Address - Street 1:451 STATE ST STE B2
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3070
Practice Address - Country:US
Practice Address - Phone:203-915-7304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003211103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty