Provider Demographics
NPI:1588117469
Name:SANDRA E FERRUCCI, LCSW, LLC
Entity type:Organization
Organization Name:SANDRA E FERRUCCI, LCSW, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:FERRUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-851-2495
Mailing Address - Street 1:11 MATTHEW CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2175
Mailing Address - Country:US
Mailing Address - Phone:203-851-2495
Mailing Address - Fax:
Practice Address - Street 1:77 WALL ST # 22
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3121
Practice Address - Country:US
Practice Address - Phone:203-851-2495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty