Provider Demographics
NPI:1316352495
Name:JAMES E SHERRY LCSW LLC
Entity type:Organization
Organization Name:JAMES E SHERRY LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-324-3329
Mailing Address - Street 1:1867 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5016
Mailing Address - Country:US
Mailing Address - Phone:203-324-3329
Mailing Address - Fax:
Practice Address - Street 1:1867 SUMMER ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5016
Practice Address - Country:US
Practice Address - Phone:203-324-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty