Fisette, Kerrie
Fisette, Kerrie is an individual health care provider with primary practice located at 365 Montauk Ave , New London CT 06320-4700. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Fisette, Kerrie can be contacted via phone (860) 442-0711.Contact Information
Primary practice address
365 Montauk Ave
New London CT 06320-4700
Phone: (860) 442-0711
Fax: (860) 444-4767
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 5037 | Connecticut |
Profile Details
| NPI number | 1831260579 |
|---|---|
| LBN Legal business name | Fisette, Kerrie |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 13th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831260579 | NPPES |
| Connecticut | MEDICAID | 4014679 | |
| Connecticut | MEDICAID | 4024972 |
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