Provider Demographics
NPI:1902606098
Name:BORDER BEHAVIORAL THERAPY LLC
Entity type:Organization
Organization Name:BORDER BEHAVIORAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED INDEPENDENT CLINICAL SOCIA
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BRISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-465-2726
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830-0001
Mailing Address - Country:US
Mailing Address - Phone:401-465-2726
Mailing Address - Fax:
Practice Address - Street 1:131 HARRISVILLE MAIN ST # 1
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:RI
Practice Address - Zip Code:02830-9998
Practice Address - Country:US
Practice Address - Phone:401-465-2726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty